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先天性肢体畸形婴儿的围产儿结局:来自中欧一家三级转诊中心的观察性研究。

Perinatal outcomes of infants with congenital limb malformations: an observational study from a tertiary referral center in Central Europe.

机构信息

Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.

Department of Pediatric Orthopedics and Adult Foot and Ankle Surgery, Orthopedic Hospital Speising, Vienna, Austria.

出版信息

BMC Pregnancy Childbirth. 2020 Jan 13;20(1):35. doi: 10.1186/s12884-020-2720-x.

Abstract

BACKGROUND

Congenital limb malformations are rare, and their perinatal outcomes are not well described. This study analyzed the perinatal outcomes of infants with congenital limb malformations.

METHODS

All infants with congenital limb malformations who underwent prenatal assessment and delivery at our tertiary referral center from 2004 through 2017 were retrospectively identified. Neonatal outcome parameters were assessed, and the predictors of worse perinatal outcomes were determined.

RESULTS

One hundred twenty-four cases of congenital limb malformations were identified, of which 104 (83.9%) were analyzed. The upper limb was affected in 15 patients (14.4%), the lower limb in 49 (47.1%), and both limbs in 40 (38.5%) patients. A fetal syndrome was identified in 66 patients (63.5%); clubfoot and longitudinal reduction defects were the most frequent malformations. In total, 38 patients (36.5%) underwent termination, seven (6.7%) had stillbirth, and 59 (56.7%) had live-born delivery. Rates of preterm delivery and transfer to the Neonatal Intensive Care Unit were 42.4 and 25.4%, respectively. Localization of the malformation was a determinant of perinatal outcome (P = .006) and preterm delivery (P = .046).

CONCLUSIONS

Congenital limb malformations frequently occur bilaterally and are associated with poor perinatal outcomes, including high rates of stillbirth and preterm delivery. Multidisciplinary care and referral to a perinatal center are warranted.

摘要

背景

先天性肢体畸形较为罕见,其围产儿结局尚未得到充分描述。本研究分析了患有先天性肢体畸形的婴儿的围产儿结局。

方法

回顾性分析 2004 年至 2017 年期间在我们的三级转诊中心接受产前评估和分娩的所有先天性肢体畸形婴儿。评估新生儿结局参数,并确定围产儿结局较差的预测因素。

结果

共发现 124 例先天性肢体畸形病例,其中 104 例(83.9%)进行了分析。上肢受累 15 例(14.4%),下肢受累 49 例(47.1%),四肢受累 40 例(38.5%)。66 例(63.5%)患者存在胎儿综合征;马蹄内翻足和纵向减少缺陷是最常见的畸形。共有 38 例(36.5%)患者终止妊娠,7 例(6.7%)死产,59 例(56.7%)分娩活产。早产和转入新生儿重症监护病房的发生率分别为 42.4%和 25.4%。畸形的定位是围产儿结局(P = .006)和早产(P = .046)的决定因素。

结论

先天性肢体畸形常为双侧性,围产儿结局较差,包括死产和早产发生率较高。需要多学科护理和转至围产中心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc62/6958570/41c3b0d60341/12884_2020_2720_Fig1_HTML.jpg

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