Holm Mari, Msall Michael E, Skranes Jon, Dammann Olaf, Allred Elizabeth, Leviton Alan
Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, N-7489 Trondheim, Norway; Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111, USA.
Department of Pediatrics, Section of Developmental and Behavioral Pediatrics and JP Kennedy Research Center on Intellectual and Developmental Disabilities, University of Chicago Comer Children's Hospital, 5721 S. Maryland Avenue, Chicago, IL 60637, USA.
Eur J Paediatr Neurol. 2015 Jan;19(1):56-63. doi: 10.1016/j.ejpn.2014.10.002. Epub 2014 Oct 12.
We sought to identify the antecedents and correlates of visual field deficits (VFDs) at age 2 years among infants born before the 28th week of gestation.
The visual fields of 1023 infants were assessed by confrontation at age 2 years. We compared the ante-and postnatal characteristics and exposures of the 65 infants with a VFD to their peers who did not have a VFD. We used time-oriented logistic regression risk models to assess the associations of potential antecedents and correlates with a VFD.
In the final regression model, VFD was associated with maternal consumption of aspirin during the current pregnancy, recurring/persistent acidemia during the first 3 postnatal days, cerebral ventriculomegaly seen on neonatal ultrasound, prethreshold retinopathy of prematurity (ROP), and supplemental oxygen and ventilator dependence at 36 weeks post-menstrual age. Birth before the 27th week was also associated with increased risk, but its significance was diminished by the addition of postnatal variables.
In this sample of extremely preterm born infants, antenatal as well as early and late postnatal characteristics and exposures are associated with an increased risk of having a VFD. Our study adds to our knowledge about the complex etiology of visual deficits of prematurity, and supports a multifactorial cause of these deficits.
我们试图确定孕28周前出生的婴儿在2岁时视野缺损(VFD)的前驱因素和相关因素。
在1023名婴儿2岁时通过面对面检查评估其视野。我们将65名有视野缺损的婴儿与其没有视野缺损的同龄人在产前和产后的特征及暴露情况进行了比较。我们使用以时间为导向的逻辑回归风险模型来评估潜在的前驱因素和相关因素与视野缺损之间的关联。
在最终回归模型中,视野缺损与母亲在本次孕期服用阿司匹林、出生后前3天反复出现/持续存在的酸血症、新生儿超声检查显示的脑室扩大、阈值前早产儿视网膜病变(ROP)以及孕龄36周时的吸氧和呼吸机依赖有关。孕27周前出生也与风险增加有关,但在加入产后变量后其显著性降低。
在这个极早产儿样本中,产前以及产后早期和晚期的特征及暴露情况与出现视野缺损的风险增加有关。我们的研究增加了我们对早产儿视力缺陷复杂病因的认识,并支持这些缺陷是多因素导致的这一观点。