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晚期早产儿的早期神经评估与长期神经运动结局:一项关键性综述。

Early Neurological Assessment and Long-Term Neuromotor Outcomes in Late Preterm Infants: A Critical Review.

机构信息

Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00146 Rome, Italy.

Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00146 Rome, Italy.

出版信息

Medicina (Kaunas). 2020 Sep 15;56(9):475. doi: 10.3390/medicina56090475.

Abstract

: Late preterm (LP) infants (born between 34 and 36 weeks of gestational age) are considered at higher risk of neonatal morbidities, mortality, and neurological impairments than full-term born infants (FT). The aim of this study was to provide a critical review of the literature outlining the different aspects of neurological function reported both in the neonatal period and in the follow up of late preterm infants. : A comprehensive search of the MEDLINE, Embase, PsycINFO, and CINAHL electronic databases was made, using the following search terms: 'Late preterm infants', 'Near term infants', 'neurological assessment', 'neurological outcome', 'neuromotor outcome', cerebral palsy', 'CP', 'motor impairment', including all the studies reporting clinical neurological assessment of LP (including both neonatal period and subsequent ages). : A total of 35 articles, comprising 301,495 children, were included as fulfilling the inclusion criteria: ten reported neonatal neurological findings, seven reported data about the first two years after birth, eighteen reported data about incidence of CP and motor disorder during the infancy. Results showed a more immature neurological profile, explored with structured neurological assessments, in LP infants compared with FT infants. The LP population also had a higher risk of developing cerebral palsy, motor delay, and coordination disorder. : LP had a higher risk of neurological impairments than FT infants, due to a brain immaturity and an increased vulnerability to injury, as the last weeks of gestational age are crucial for the development of the brain.

摘要

晚期早产儿(LP)(出生于妊娠 34 至 36 周之间)比足月儿(FT)面临更高的新生儿发病风险、死亡率和神经损伤风险。本研究旨在对文献进行综述,概述在新生儿期和晚期早产儿随访期间报告的不同神经功能方面。

使用以下搜索词,对 MEDLINE、Embase、PsycINFO 和 CINAHL 电子数据库进行了全面检索:“晚期早产儿”、“近足月儿”、“神经评估”、“神经结局”、“神经运动结局”、“脑瘫”、“CP”、“运动障碍”,包括所有报告 LP 临床神经评估的研究(包括新生儿期和后续年龄)。

共有 35 篇文章,包括 301495 名儿童,符合纳入标准:其中 10 篇报告了新生儿神经学发现,7 篇报告了出生后前两年的数据,18 篇报告了婴儿期脑瘫和运动障碍发生率的数据。结果显示,与 FT 婴儿相比,LP 婴儿的神经发育更不成熟,这是通过结构化神经评估来探索的。LP 人群也有更高的脑瘫、运动迟缓、协调障碍的发病风险。

LP 比 FT 婴儿有更高的神经损伤风险,这是由于大脑发育不成熟和对损伤的易感性增加,因为妊娠的最后几周对大脑发育至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f6/7558342/30bfa15cb293/medicina-56-00475-g001.jpg

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