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18-24 个月校正胎龄时极低出生体重儿的神经发育结局:一项三级医疗中心的前瞻性队列研究。

Neurodevelopmental Outcomes of Very Low Birth Weight Infants at 18-24 Months, Corrected Gestational Age in a Tertiary Health Centre: A Prospective Cohort Study.

机构信息

Developmental Pediatrics Unit, Christian Medical College, Vellore, Tamil Nadu, India.

Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, India.

出版信息

J Trop Pediatr. 2019 Dec 1;65(6):552-560. doi: 10.1093/tropej/fmz006.

Abstract

OBJECTIVE

To determine the prevalence and risk factors for poor neurodevelopmental outcome in a cohort of very low birth weight (VLBW) infants.

SUBJECTS AND METHODS

Four hundred and twenty-two infants of a total of 643 VLBW survivors from a teaching hospital in South India were followed up to assess their neurodevelopmental outcomes.

RESULTS

Among the 422 children who completed the assessment, results of 359 children whose assessments were done between 18 and 24 months were analysed. Thirty-seven children (10.31%) had poor neurodevelopmental outcome, six children [1.67%] had cerebral palsy, one child had visual impairment and another had hearing impairment. Poor post-natal growth was independently associated with poor neurodevelopmental outcomes in the multivariate analysis (p = 0.045). Neonatal complications were not associated with the developmental outcome.

CONCLUSION

Despite lower rates of neonatal complications compared with Western cohorts, significant proportion of VLBW infants had poor neurodevelopmental outcomes. Poor post-natal growth was an important determinant of the developmental outcome.

摘要

目的

确定印度南部一家教学医院的极低出生体重(VLBW)存活儿队列中不良神经发育结局的发生率和危险因素。

方法

对 643 例 VLBW 存活儿中的 422 例进行随访,以评估其神经发育结局。

结果

在完成评估的 422 名儿童中,对 359 名评估时间在 18 至 24 个月之间的儿童的结果进行了分析。37 名儿童(10.31%)存在不良神经发育结局,6 名儿童(1.67%)患有脑瘫,1 名儿童存在视力障碍,另 1 名儿童存在听力障碍。多变量分析显示,出生后生长不良与不良神经发育结局独立相关(p=0.045)。新生儿并发症与发育结局无关。

结论

尽管与西方队列相比,新生儿并发症发生率较低,但仍有相当比例的 VLBW 婴儿存在不良神经发育结局。出生后生长不良是发育结局的重要决定因素。

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