Tskimanauri N, Khachapuridze N, Imnadze P, Chanadiri T, Bakhtadze S
Tbilisi State Medical University; Neurological Clinic LTD "Valeo", Tbilisi; I. Javakhishvili Tbilisi State University, Georgia.
Georgian Med News. 2017 Dec(273):75-81.
The purpose of this research was to investigate the developmental follow-up of infants (at age of 6 month and 12 month), exposed to separate and combination impact of perinatal risk factors, compared with not exposed cases, within the prospective cohort study. Between January 2015 and January 2017, in this research we prospectively enrolled 1018 live-born infants from the medical reports of the participating clinics in Tbilisi (capital of Republic of Georgia) and Mtskheta, Dusheti (districts of Georgia). Within postnatal follow-up, the children from whole population were assessed at 6 and 12 months of age by family doctors using the Denver Developmental Screening Test (Denver II). The association between the risk factors and neurodevelopmental outcomes was analyzed by Chi-square test of independence. Statistical analysis of these data was performed using the SPSS version 12. (SPSS Inc., Chicago, IL). A P value of less than 0.05 was considered as significant. Prevalence of abnormal development in whole population was revealed 9.0% or 92 cases at age of 6 month and 36 cases or 3.5% at age of 12 month. Point prevalence of farther neurodevelopmental adversities for healthy born children not influenced by studied risk factors was 0.1% and for infants with impact of the risk factors - 1.5%; on the other hand, prevalence of observed abnormal development in infant's population who had neonatal pathologies was 2.3% if risk factors were not exposed and 21.6% under influence of risk factors. Statistical analysis showed that an abnormal developmental outcomes were more frequent when researched risk factors were exposed (OR-23.18, CI 95% - 11.83 to 45.41 - at age of 6 month; OR - 26.12, CI 95% - 7.95 to 85.85 - at age of 12 month) as well, as correlation of these risk factors with neurodevelopmental adverse outcomes was significant (p<0.001). Significant correlations were identified for separate risk factors, such as maternal age (<17Y>35Y), pathologies of pregnancy and delivery as well as gestation age (<37 weeks). Coexistence of revealed risk factors increased probability of adverse neurological outcomes in infants at age of 6 month as well as at age of 12 month. There was a statistically important association between infant's 1-year neurological outcomes and these perinatal risk factors.
本研究的目的是在前瞻性队列研究中，调查暴露于围产期风险因素单独及联合影响下的婴儿（6个月和12个月大）的发育随访情况，并与未暴露的病例进行比较。2015年1月至2017年1月期间，在本研究中，我们从第比利斯（格鲁吉亚共和国首都）以及姆茨赫塔、杜舍蒂（格鲁吉亚的地区）参与研究的诊所的医疗报告中前瞻性招募了1018名活产婴儿。在产后随访中，家庭医生使用丹佛发育筛查测试（丹佛Ⅱ）在6个月和12个月大时对全体儿童进行评估。通过独立性卡方检验分析风险因素与神经发育结局之间的关联。使用SPSS 12版（SPSS公司，伊利诺伊州芝加哥）对这些数据进行统计分析。P值小于0.05被认为具有统计学意义。在全体人群中，6个月大时异常发育的患病率为9.0%，即92例；12个月大时为36例，即3.5%。未受所研究风险因素影响的健康出生儿童远期神经发育不良的点患病率为0.1%，受风险因素影响的婴儿为1.5%；另一方面，有新生儿疾病的婴儿人群中，未暴露于风险因素时观察到的异常发育患病率为2.3%，受风险因素影响时为21.6%。统计分析表明，当研究的风险因素暴露时，异常发育结局更常见（6个月大时，OR-23.18，95%CI-11.83至45.41；12个月大时，OR-26.12，95%CI-7.95至85.85），并且这些风险因素与神经发育不良结局的相关性显著（p<0.001）。对于单独的风险因素，如母亲年龄（<17岁或>35岁）、妊娠和分娩病理以及孕周（<37周），也发现了显著相关性。所揭示风险因素的共存增加了6个月大以及12个月大婴儿出现不良神经结局的可能性。婴儿1岁时的神经结局与这些围产期风险因素之间存在统计学上的重要关联。
