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新生儿重症监护病房出院时血红蛋白浓度与早产儿神经发育结局标志物之间的关联。

Association between hemoglobin concentrations at discharge from the neonatal intensive care unit with markers of neurodevelopmental outcomes in premature neonates.

作者信息

Kratimenos Panagiotis, Christidis Panagiotis, Kehinde Folasade, Koutroulis Ioannis, Santana Stephanie, Mossabeb Roschanak, Fleishman Rachel

机构信息

Drexel University College of Medicine, St. Christopher's Hospital for Children and Temple University Hospital, Philadelphia, PA, USA.

Department of Pediatrics, Division of Neonatology, Children's National Medical Center, George Washington University, School of Medicine and Health Sciences, Washington, DC, USA.

出版信息

J Neonatal Perinatal Med. 2019;12(2):221-230. doi: 10.3233/NPM-1822.

Abstract

BACKGROUND

Premature neonates are often subjected to multiple transfusions with red blood cells during their hospitalization in the neonatal intensive care unit (NICU). The hemoglobin threshold for transfusion prior to discharge from the NICU varies significantly among different centers. The aim of the present study is to investigate the association between hemoglobin concentration at discharge with neurodevelopmental outcomes in premature neonates.

METHODS

Retrospective observation study with regression analysis was performed with follow up assessment in the neuro-developmental outpatient clinic at 30 months of adjusted age.

RESULTS

Data from 357 neonates born at less than 37 weeks' gestation were analyzed. Sensory and motor neurodevelopment at 30 months of adjusted age, were not associated with the hemoglobin concentration at discharge (p=0.5891 and p=0.4575, respectively). There was no association between the hemoglobin concentration at discharge with fine or gross motor development (p=0.1582 and p=0.3805, respectively). Hemoglobin concentration at discharge was not associated with poor neurodevelopmental outcomes up until 30 months of adjusted age.

CONCLUSIONS

The data of the present study indicate that the hemoglobin concentration of premature neonates at the time of discharge is not associated with poorer markers of neurodevelopmental outcomes at 30 months of adjusted age. Comorbidities such as BPD and IVH that are present to premature neonates were identified as potential risk factors for certain aspects of the neurodevelopment.

摘要

背景

早产新生儿在新生儿重症监护病房(NICU)住院期间经常接受多次红细胞输血。不同中心之间,NICU出院前输血的血红蛋白阈值差异很大。本研究的目的是调查早产新生儿出院时血红蛋白浓度与神经发育结局之间的关联。

方法

进行回顾性观察研究及回归分析,并在矫正年龄30个月时在神经发育门诊进行随访评估。

结果

分析了357例孕周小于37周出生的新生儿的数据。矫正年龄30个月时的感觉和运动神经发育与出院时的血红蛋白浓度无关(分别为p = 0.5891和p = 0.4575)。出院时的血红蛋白浓度与精细或粗大运动发育之间无关联(分别为p = 0.1582和p = 0.3805)。直到矫正年龄30个月,出院时的血红蛋白浓度与不良神经发育结局均无关联。

结论

本研究数据表明,早产新生儿出院时的血红蛋白浓度与矫正年龄30个月时较差的神经发育结局指标无关。早产新生儿存在的诸如支气管肺发育不良(BPD)和脑室内出血(IVH)等合并症被确定为神经发育某些方面的潜在危险因素。

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