Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil.
Universidade Federal de São Paulo (Unifesp), Departamento de Pediatria, Divisão de Pediatria Neonatal, São Paulo, SP, Brazil.
J Pediatr (Rio J). 2019 Nov-Dec;95(6):728-735. doi: 10.1016/j.jped.2018.06.009. Epub 2018 Jul 27.
To evaluate the association between intra-ventricular hemorrhage and habituation responses to external stimuli in preterm infants at 36-38 weeks post-conceptual age.
Cross-sectional study of infants with gestational age <32 weeks. Intra-ventricular hemorrhage was identified by cranial ultrasonography and classified according to Papile et al. (1978). The luminous (flashlight), sound (rattle, bell), and tactile stimuli were presented, and the responses were scored according to Lester and Tronik (2004). Habituation response scores were compared between groups by Student's t-test. The association between IVH and habituation scores was evaluated by linear regression adjusted for GA, clinical severity score, post-conceptual age at habituation assessment, sepsis, and bronchopulmonary dysplasia.
Sixty-five infants were studied, 20 with intra-ventricular hemorrhage (16 grades I/II; four grades III/IV) and 45 without intra-ventricular hemorrhage. Infants with intra-ventricular hemorrhage had lower gestational age (28.2±2.2 vs. 29.7±1.7 weeks) and birth weight (990±305 vs. 1275±360g). Infants with intra-ventricular hemorrhage at 36-38 weeks post-conceptual age had lower habituation scores to light (4.21±2.23 vs. 6.09±2.44), rattle (3.84±2.12 vs. 6.18±2.27), and bell (3.58±1.74 vs. 5.20±2.47) after controlling for confounders. No differences were found for tactile stimulus.
Infants with gestational age <32 weeks and intra-ventricular hemorrhage had poorer habituation responses to external stimuli than those without intra-ventricular hemorrhage at 36-38 weeks post-conceptual age.
评估胎龄<32 周的早产儿在纠正胎龄 36-38 周时，脑室周围出血（IVH）与对外界刺激习惯化反应之间的关系。
这是一项对胎龄<32 周的婴儿进行的横断面研究。通过头颅超声检查确定脑室周围出血，并按照 Papile 等（1978）的分类进行分类。给予光（闪光灯）、声（拨浪鼓、铃铛）和触觉刺激，并根据 Lester 和 Tronik（2004）进行评分。通过学生 t 检验比较两组的习惯化反应评分。通过线性回归调整胎龄、临床严重程度评分、习惯化评估时的纠正胎龄、败血症和支气管肺发育不良，评估 IVH 与习惯化评分之间的关系。
共研究了 65 名婴儿，20 名有脑室周围出血（16 级 I/II；4 级 III/IV），45 名无脑室周围出血。有脑室周围出血的婴儿胎龄（28.2±2.2 与 29.7±1.7 周）和出生体重（990±305 与 1275±360g）较低。在纠正胎龄 36-38 周时，有脑室周围出血的婴儿对光（4.21±2.23 与 6.09±2.44）、拨浪鼓（3.84±2.12 与 6.18±2.27）和铃铛（3.58±1.74 与 5.20±2.47）的习惯化评分较低，在控制混杂因素后。触觉刺激无差异。
胎龄<32 周且有脑室周围出血的婴儿在纠正胎龄 36-38 周时对外界刺激的习惯化反应较无脑室周围出血的婴儿差。
