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胎盘病理学可预测日本人群婴儿在出生后 18 个月内的体格发育:滨松母婴队列研究(HBC 研究)。

Placental pathology predicts infantile physical development during first 18 months in Japanese population: Hamamatsu birth cohort for mothers and children (HBC Study).

机构信息

Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.

出版信息

PLoS One. 2018 Apr 10;13(4):e0194988. doi: 10.1371/journal.pone.0194988. eCollection 2018.

Abstract

The present study aimed to investigate the relationship between placental pathological findings and physiological development during the neonate and infantile periods. Study participants were 258 infants from singleton pregnancies enrolled in the Hamamatsu Birth Cohort for Mothers and Children (HBC Study) whose placentas were stored in our pathological division. They were followed up from birth to 18 months of age. Physiological development (body weight and the ponderal index [PI]) was assessed at 0, 1, 4, 6, 10, 14, and 18 months. Placental blocks were prepared by random sampling and eleven pathological findings were assessed, as follows: 'Accelerated villous maturation', 'Decidual vasculopathy', 'Thrombosis or Intramural fibrin deposition', 'Avascular villi', 'Delayed villous maturation', 'Maternal inflammatory response', 'Fetal inflammatory response', 'Villitis of unknown etiology (VUE)', 'Deciduitis', 'Maternal vascular malperfusion', and 'Fetal vascular malperfusion'. Mixed model analysis with the use of the xtmixed command by the generic statistical software, Stata version 13.1., identified 'Accelerated villous maturation' and 'Maternal vascular malperfusion' as significant predictors of a lower body weight and 'Deciduitis' as a significant predictor of a small PI, throughout the first 18 months of life. In conclusion, the present study is the first to demonstrate that some pathological findings of the placenta are associated with changes in infantile physical development during the initial 18 months of life in the Japanese population.

摘要

本研究旨在探讨胎盘病理发现与新生儿和婴儿期生理发育之间的关系。研究参与者为 258 名来自单胎妊娠的婴儿,他们参加了滨松母婴队列研究(HBC 研究),其胎盘储存在我们的病理科。从出生到 18 个月对他们进行了随访。在 0、1、4、6、10、14 和 18 个月时评估生理发育(体重和体质量指数 [PI])。通过随机抽样制备胎盘块,并评估了 11 种病理发现,如下所示:“绒毛加速成熟”、“蜕膜血管病变”、“血栓或壁内纤维蛋白沉积”、“无血管绒毛”、“绒毛成熟延迟”、“母体炎症反应”、“胎儿炎症反应”、“原因不明的绒毛膜炎(VUE)”、“蜕膜炎”、“母体血管灌注不良”和“胎儿血管灌注不良”。使用通用统计软件 Stata 版本 13.1 的 xtmixed 命令进行混合模型分析,确定“绒毛加速成熟”和“母体血管灌注不良”是体重较低的显著预测因素,“蜕膜炎”是 PI 较小的显著预测因素,这两个因素贯穿婴儿生命的头 18 个月。总之,本研究首次表明,胎盘的某些病理发现与日本人群在生命最初 18 个月内婴儿身体发育的变化有关。

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