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胎盘早剥所致新生儿脑瘫的危险因素。

Risk factors for cerebral palsy in neonates due to placental abruption.

作者信息

Ichizuka Kiyotake, Toyokawa Satoshi, Ikenoue Tsuyomu, Satoh Shoji, Hasegawa Junichi, Ikeda Tomoaki, Tamiya Nanako, Nakai Akihito, Fujimori Keiya, Maeda Tsugio, Kanayama Naohiro, Masuzaki Hideaki, Iwashita Mitsutoshi, Suzuki Hideaki, Takeda Satoru

机构信息

Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.

Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Japan.

出版信息

J Obstet Gynaecol Res. 2021 Jan;47(1):159-166. doi: 10.1111/jog.14447. Epub 2020 Sep 3.

Abstract

AIM

This study aimed to identify risk factors for the onset of cerebral palsy (CP) in neonates due to placental abruption and investigate their characteristics.

METHODS

A retrospective case-control study was conducted using a nationwide registry from Japan. The study population included pregnant women (n = 122) who delivered an infant with CP between 2009 and 2015, where placental abruption was identified as the single cause of CP. The control group consisted of pregnant women with placental abruption, who delivered an infant without CP and were managed from 2013 to 2014. They were randomly identified from the prenatal database of the Japan Society of Obstetrics and Gynecology (JSOG-DB; n = 1214). Risk factors were investigated using multivariate analysis.

RESULTS

Alcohol consumption (3.38, 2.01-5.68) (odds ratio, 95% confidence interval), smoking during pregnancy (3.50, 1.32-9.25), number of deliveries (1.28, 1.05-1.56), polyhydramnios (5.60, 1.37-22.6), oral administration of ritodrine hydrochloride (2.09, 1.22-3.57) and hypertensive disorders in pregnancy (2.25, 1.27-4.07) were significant risk factors. In contrast, intravenous administration of oxytocin (odds ratio, 95% confidence interval: 0.22, 0.09-0.58) and magnesium sulfate (0.122, 0.02-0.89) attenuated risk.

CONCLUSION

Alcohol consumption, smoking during pregnancy, number of deliveries, polyhydramnios, oral administration of ritodrine hydrochloride and hypertensive disorders in pregnancy were identified as risk factors for CP following placental abruption. Regarding alcohol consumption and smoking during pregnancy, the results suggest the importance of educational activities targeting pregnant women to increase their awareness of placental abruption.

摘要

目的

本研究旨在确定因胎盘早剥导致新生儿脑瘫(CP)发病的危险因素,并调查其特征。

方法

使用日本全国性登记处进行回顾性病例对照研究。研究人群包括2009年至2015年间分娩出患有CP婴儿的孕妇(n = 122),其中胎盘早剥被确定为CP的唯一病因。对照组由患有胎盘早剥、分娩出无CP婴儿且在2013年至2014年接受管理的孕妇组成。她们是从日本妇产科学会产前数据库(JSOG-DB;n = 1214)中随机确定的。使用多变量分析研究危险因素。

结果

饮酒(3.38,2.01 - 5.68)(比值比,95%置信区间)、孕期吸烟(3.50,1.32 - 9.25)、分娩次数(1.28,1.05 - 1.56)、羊水过多(5.60,1.37 - 22.6)、口服盐酸利托君(2.09,1.22 - 3.57)和妊娠期高血压疾病(2.25,1.27 - 4.07)是显著的危险因素。相比之下,静脉注射缩宫素(比值比,95%置信区间:0.22,0.09 - 0.58)和硫酸镁(0.122,0.02 - 0.89)可降低风险。

结论

饮酒、孕期吸烟、分娩次数、羊水过多、口服盐酸利托君和妊娠期高血压疾病被确定为胎盘早剥后发生CP的危险因素。关于饮酒和孕期吸烟,结果表明针对孕妇开展教育活动以提高其对胎盘早剥认识的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f29/7818445/c594ee304873/JOG-47-159-g001.jpg

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