Kumpulainen Venla, Lehtola Satu J, Tuulari Jetro J, Silver Eero, Copeland Anni, Korja Riikka, Karlsson Hasse, Karlsson Linnea, Merisaari Harri, Parkkola Riitta, Saunavaara Jani, Lähdesmäki Tuire, Scheinin Noora M
FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.
Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland.
Front Neurol. 2020 Jan 8;10:1347. doi: 10.3389/fneur.2019.01347. eCollection 2019.
Birth is a traumatic event with molding forces directed to the fetal skull, which may result in intracranial hemorrhages. However, the knowledge on prevalence and risk factors of incidental brain magnetic resonance imaging (MRI) findings in infants is still inconclusive. The prevalence and nature of incidental MRI findings were assessed in a birth cohort of 175 asymptomatic infants. The role of delivery method as well as other potential risk factors for intracranial hemorrhages were evaluated. The infants underwent 3T MRI at the age of 2-5 weeks, and the neurological status of the infants with an incidental finding was evaluated by a pediatric neurologist. Information on the delivery method, duration of delivery, parity, used anesthesia, oxytocin induction, and Apgar score was gathered to evaluate their association with the prevalence of hemorrhages. Incidental intracranial hemorrhages were detected in 12 infants (6.9%), all following spontaneous or assisted vaginal delivery. Vacuum-assistance was found to be a risk factor for subdural hemorrhages with an odds ratio (OR) of 4.7 (95% CI [1.18; 18.9], = 0.032). All infants were evaluated to develop normally by their clinical status. Incidental intracranial hemorrhages are relatively common among infants born by vaginal delivery. They are often of little clinical significance within the first years of life and have unlikely consequences for later neurodevelopment either. Despite their benign character, investigators should be prepared to share this information with parents competently as the findings can cause parental anxiety, and especially as the popularity of MRI as a research tool is increasing.
分娩是一个具有指向胎儿颅骨塑形力的创伤性事件,这可能导致颅内出血。然而,关于婴儿脑部磁共振成像(MRI)偶然发现的患病率和危险因素的知识仍无定论。在175名无症状婴儿的出生队列中评估了MRI偶然发现的患病率和性质。评估了分娩方式以及颅内出血的其他潜在危险因素的作用。这些婴儿在2至5周龄时接受了3T MRI检查,一名儿科神经科医生对有偶然发现的婴儿的神经状况进行了评估。收集了有关分娩方式、分娩持续时间、产次、使用的麻醉、催产素引产和阿普加评分的信息,以评估它们与出血患病率的关联。在12名婴儿(6.9%)中检测到偶然的颅内出血,均发生在自然分娩或辅助阴道分娩之后。发现真空辅助是硬膜下出血的一个危险因素,优势比(OR)为4.7(95%可信区间[1.18;18.9],P = 0.032)。所有婴儿经临床评估发育正常。偶然的颅内出血在经阴道分娩的婴儿中相对常见。它们在生命的头几年通常临床意义不大,对后期神经发育也不太可能有影响。尽管其性质良性,但研究人员应准备好向家长妥善分享这些信息,因为这些发现可能会引起家长焦虑,尤其是随着MRI作为一种研究工具的普及程度不断提高。