Neonatal Intensive Care Unit, Department of Pediatrics, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France; EA 4607 SNA EPIS, Université de Lyon, Université Jean Monnet, Saint-Étienne, France.
Department of Clinical Research and Pharmacology, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France.
Eur J Paediatr Neurol. 2020 Sep;28:126-132. doi: 10.1016/j.ejpn.2020.06.008. Epub 2020 Jul 13.
To test the association between exposure to perinatal inflammation - i.e. clinical chorioamnionitis or early-onset neonatal infection - in preterm children without severe neonatal brain injury and neurodevelopmental outcome at 30 months of corrected age (CA).
Cross-sectional study from a French regional cohort of clinical follow-up (SEVE Network).
One hundred sixty-four surviving neonates without severe brain injury - namely, grade III and IV cerebral hemorrhage and cystic periventricular leukomalacia - and without late-onset neonatal inflammation exposure - namely, late-onset neonatal infection and necrotizing enterocolitis -, born at less than 33 weeks of gestational age from November 2011 to June 2015 and enrolled in the SEVE Network.
Global developmental quotient (DQ) score of the revised Brunet-Lézine scale and its four indices measured by the same neuropsychologist at 30 months of CA.
After multivariate analysis, exposure to perinatal inflammation was not found significantly associated with a modification of the global DQ score (coefficient -1.7, 95% CI -4.8 to 1.3; p = 0.26). Exposure to perinatal inflammation was associated with a decrease of the gross motor function DQ score (coefficient -6.0, 95% CI -9.9 to -2.1; p < 0.01) and a decrease of the sociability DQ score (coefficient -5.1, 95% CI -9.2 to -0.9; p = 0.02). Language and visuospatial coordination DQ scores were not affected by exposure to perinatal inflammation.
Exposure to perinatal inflammation in preterm children without severe neonatal brain injury is independently associated with decreased motor and social abilities at 30 months of CA.
研究未患有严重新生儿脑损伤的早产儿在围产期暴露于炎症（即临床绒毛膜羊膜炎或早发型新生儿感染）与 30 个月校正年龄（CA）时神经发育结局之间的关系。
来自法国临床随访的区域队列（SEVE 网络）的横断面研究。
2011 年 11 月至 2015 年 6 月期间，在妊娠 33 周前出生且未患有严重脑损伤（即 3 级和 4 级脑室内出血和囊性室管膜下白质软化症）和未患有晚发型新生儿炎症（即晚发型新生儿感染和坏死性小肠结肠炎）的 164 例存活新生儿，纳入 SEVE 网络。
采用修订后的 Brunet-Lézine 量表评估的整体发育商（DQ）评分及其由同一位神经心理学家在 30 个月 CA 时评估的 4 个指数。
多元分析后发现，围产期炎症暴露与整体 DQ 评分的改变无显著相关性（系数为-1.7，95%CI-4.8 至 1.3；p=0.26）。围产期炎症暴露与粗大运动功能 DQ 评分降低（系数为-6.0，95%CI-9.9 至-2.1；p<0.01）和社会交往 DQ 评分降低（系数为-5.1，95%CI-9.2 至-0.9；p=0.02）相关。语言和视空间协调 DQ 评分不受围产期炎症暴露的影响。
未患有严重新生儿脑损伤的早产儿围产期炎症暴露与 30 个月 CA 时运动和社会能力下降独立相关。
