Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Beer-Sheva, Israel.
Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Arch Gynecol Obstet. 2021 Mar;303(3):703-708. doi: 10.1007/s00404-020-05788-9. Epub 2020 Sep 15.
The purpose of our study was to evaluate the effect of IPI on long-term neurological morbidity of the offspring.
In this retrospective cohort study, 144,397 singleton infants born to multiparous mothers, between the years 1991 and 2014 in a tertiary medical center, were evaluated for different perinatal outcomes and were followed until 18 years of age for long-term neurological morbidity according to three IPI groups: Short IPI (< 6 months), long IPI (> 60 months) and intermediate IPI (6-60 months). We used a Kaplan-Meier survival curve to compare cumulative incidence of long-term neurological morbidity, and a Cox regression analysis to control for confounders such as gestational age, birth weight and maternal age.
Offspring born to mothers with long IPI had higher rates of neurological morbidity (3.62% among offspring born after long IPI vs. 3.18% and 3.19% among offspring born after short and intermediate IPI, respectively, p = 0.041). The cumulative incidence of long-term neurological morbidity was significantly higher in the long IPI group (Kaplan-Meier log-rank test p < 0.001). Being born after a long IPI was found to be an independent risk factor for long-term neurological morbidity of the offspring (adjusted hazard ratio 1.2; 95% confidence interval 1.1-1.4; p < 0.001).
Long IPI is independently associated with an increased risk of long-term neurological morbidity of the offspring.
我们研究的目的是评估 IPI 对后代长期神经发育不良的影响。
在这项回顾性队列研究中，评估了 1991 年至 2014 年间在一家三级医疗中心分娩的 144397 名多胎母亲的单胎婴儿的不同围产期结局，并根据 IPI 的三个组别（短 IPI[<6 个月]、长 IPI[>60 个月]和中 IPI[6-60 个月]）随访至 18 岁，以评估其长期神经发育不良的情况。我们使用 Kaplan-Meier 生存曲线比较长期神经发育不良的累积发生率，并使用 Cox 回归分析控制围产期年龄、出生体重和产妇年龄等混杂因素。
长 IPI 母亲所生的后代发生神经发育不良的比例较高（长 IPI 后出生的后代中发生率为 3.62%，而短 IPI 和中 IPI 后出生的后代中发生率分别为 3.18%和 3.19%，p=0.041）。长 IPI 组的长期神经发育不良的累积发生率明显更高（Kaplan-Meier 对数秩检验 p<0.001）。长 IPI 后出生被发现是后代长期神经发育不良的独立危险因素（调整后的危险比 1.2；95%置信区间 1.1-1.4；p<0.001）。
长 IPI 与后代长期神经发育不良的风险增加独立相关。
