Courteau C, Samman K, Ali N, Riley P, Wintermark P
Division of Newborn Medicine, Department of Pediatrics, McGill University, Montreal, QC, Canada.
Division of Newborn Medicine, Department of Pediatrics, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, QC, Canada.
Acta Paediatr. 2016 Sep;105(9):e396-405. doi: 10.1111/apa.13463. Epub 2016 Jun 3.
To identify additional risk factors other than asphyxia and hypothermia in newborns developing subcutaneous fat necrosis (SCFN).
We conducted a prospective cohort study of all term asphyxiated newborns treated with hypothermia from 2008 to 2015. The presence and location of SCFN were recorded at the time of discharge or at follow-up visits. To identify the risk factors for developing SCFN, we compared the perinatal characteristics of those newborns who developed SCFN with those who did not.
The newborns developing SCFN had significantly higher birthweights compared with those newborns who did not develop SCFN. Among the newborns with a birthweight equal or superior to the 90th percentile, those who developed SCFN had a significantly higher use of inotropic support and higher maximum troponin levels during their initial hospitalisation.
A higher birthweight represented an independent risk factor for developing SCFN in asphyxiated newborns treated with hypothermia. When macrosomia is present, other risk factors related to haemodynamic instability during the initial hospitalisation may also increase the risk of developing SCFN.
确定除窒息和体温过低外,发生皮下脂肪坏死(SCFN)的新生儿的其他风险因素。
我们对2008年至2015年期间所有接受低温治疗的足月儿窒息新生儿进行了一项前瞻性队列研究。在出院时或随访时记录SCFN的存在情况和位置。为了确定发生SCFN的风险因素,我们比较了发生SCFN的新生儿与未发生SCFN的新生儿的围产期特征。
与未发生SCFN的新生儿相比,发生SCFN的新生儿出生体重显著更高。在出生体重等于或高于第90百分位数的新生儿中,发生SCFN的新生儿在初次住院期间使用血管活性药物支持的比例显著更高,肌钙蛋白最高水平也更高。
较高的出生体重是接受低温治疗的窒息新生儿发生SCFN的独立风险因素。当存在巨大儿时,初次住院期间与血流动力学不稳定相关的其他风险因素也可能增加发生SCFN的风险。