Casavant Sharon G, Cong Xiaomei, Moore James, Starkweather Angela
School of Nursing, University of Connecticut, 231 Glenbrook Road, U-2026, Storrs, CT 06269, USA; Neonatal Intensive Care Unit, The Hospital of Central Connecticut, 100 Grand Street, New Britain, CT 06052, USA.
School of Nursing, University of Connecticut, 231 Glenbrook Road, U-2026, Storrs, CT 06269, USA.
Early Hum Dev. 2019 Apr;131:63-74. doi: 10.1016/j.earlhumdev.2019.03.003. Epub 2019 Mar 11.
Every year, an estimated 15 million babies are born preterm (<37 weeks' gestational age [GA]) globally. These preterm infants are exposed to repeated stressful and often painful procedures as part of routine life-saving care within the neonatal intensive care unit (NICU). Preterm birth continues to be a major health issue associated with increased risk of neurodevelopmental and behavioral disorders such as cerebral palsy, cognitive impairment, autism spectrum disorders and psychiatric disease.
This paper identifies epigenetic alterations and incidence of telomere erosion that have been studied in preterm infants while in the NICU and as a long-term outcome measure. Better understanding of epigenetic alterations and telomere erosion might aid in early detection and prevention/alleviation of the negative effects of cumulative painful/stressful experiences in this population.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to guide this review. Systematic searches of databases included PubMed, CINAHL, SCOPUS and PsychInfo.
Twenty-one studies were included, appraised and then synthesized into a narrative summary.
Several putative epigenetic markers were identified although there was a paucity of studies related to telomere length. The interaction of disease entity combined with therapeutic interventions intended to treat may inadvertently increase infant allostatic load or ability to adapt to stress. Future research should include not only human studies but leverage newly available large data sets to conduct additional analysis.
全球每年估计有1500万婴儿早产（胎龄<37周）。作为新生儿重症监护病房（NICU）常规挽救生命护理的一部分，这些早产儿会经历反复的压力性且通常是痛苦的操作。早产仍然是一个主要的健康问题，与神经发育和行为障碍风险增加相关，如脑瘫、认知障碍、自闭症谱系障碍和精神疾病。
本文确定了在NICU中的早产儿以及作为长期结局指标所研究的表观遗传改变和端粒侵蚀发生率。更好地理解表观遗传改变和端粒侵蚀可能有助于早期发现和预防/减轻该人群累积的痛苦/压力性经历的负面影响。
采用系统评价和Meta分析的首选报告项目（PRISMA）标准来指导本综述。对包括PubMed、CINAHL、SCOPUS和PsychInfo在内的数据库进行系统检索。
纳入、评估了21项研究，然后综合成叙述性总结。
尽管与端粒长度相关的研究较少，但确定了几个假定的表观遗传标记。疾病实体与旨在治疗的治疗干预措施之间的相互作用可能会无意中增加婴儿的应激负荷或适应压力的能力。未来的研究不仅应包括人体研究，还应利用新获得的大数据集进行额外分析。
