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校正 18 月龄时孕 34 周和 35 周早产儿的神经发育结局。

Neurodevelopmental Outcomes at 18 Months of Corrected Age for Late Preterm Infants Born at 34 and 35 Gestational Weeks.

机构信息

Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan.

Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe 6500017, Japan.

出版信息

Int J Environ Res Public Health. 2021 Jan 13;18(2):640. doi: 10.3390/ijerph18020640.

DOI:10.3390/ijerph18020640
PMID:33451096
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7828522/
Abstract

To date, the difference in neurodevelopmental outcomes between late preterm infants (LPI) born at 34 and 35 gestational weeks (LPI-34 and LPI-35, respectively) has not been elucidated. This retrospective study aimed to evaluate neurodevelopmental outcomes at 18 months of corrected age for LPI-34 and LPI-35, and to elucidate factors predicting neurodevelopmental impairment (NDI). Records of all LPI-34 ( = 93) and LPI-35 ( = 121) admitted to our facility from 2013 to 2017 were reviewed. Patients with congenital or chromosomal anomalies, severe neonatal asphyxia, and without developmental quotient (DQ) data were excluded. Psychomotor development was assessed as a DQ using the Kyoto Scale of Psychological Development at 18 months of corrected age. NDI was defined as DQ <80 or when severe neurodevelopmental problems made neurodevelopmental assessment impossible. We compared the clinical characteristics and DQ values between LPI-34 (n = 62) and LPI-35 ( = 73). To elucidate the factors predicting NDI at 18 months of corrected age, we compared clinical factors between the NDI ( = 17) and non-NDI ( = 118) groups. No significant difference was observed in DQ values at 18 months of corrected age between the groups in each area and overall. Among clinical factors, male sex, intraventricular hemorrhage (IVH), hyperbilirubinemia, and severe hyperbilirubinemia had a higher prevalence in the NDI group than in the non-NDI group, and IVH and/or severe hyperbilirubinemia showed the highest Youden Index values for predicting NDI. Based on the results of this study, we can conclude that no significant difference in neurodevelopmental outcomes at 18 months of corrected age was observed between LPI-34 and LPI-35. Patients with severe hyperbilirubinemia and/or IVH should be considered to be at high risk for developing NDI.

摘要

迄今为止,孕 34 周和 35 周(分别为 LPI-34 和 LPI-35)出生的晚期早产儿(LPI)之间神经发育结局的差异尚未阐明。本回顾性研究旨在评估 18 个月校正年龄时 LPI-34 和 LPI-35 的神经发育结局,并阐明预测神经发育障碍(NDI)的因素。回顾了 2013 年至 2017 年期间我院收治的所有 LPI-34(n=93)和 LPI-35(n=121)患者的记录。排除了存在先天性或染色体异常、严重新生儿窒息且无发育商(DQ)数据的患者。18 个月校正年龄时,使用京都心理发育量表评估精神运动发育情况作为 DQ。NDI 定义为 DQ<80 或严重神经发育问题导致神经发育评估不可能。我们比较了 LPI-34(n=62)和 LPI-35(n=73)之间的临床特征和 DQ 值。为了阐明 18 个月校正年龄时预测 NDI 的因素,我们比较了 NDI 组(n=17)和非 NDI 组(n=118)之间的临床因素。在每个区域和总体上,两组在 18 个月校正年龄时的 DQ 值均无显著差异。在临床因素中,男性、脑室周围出血(IVH)、高胆红素血症和严重高胆红素血症在 NDI 组中的发生率高于非 NDI 组,IVH 和/或严重高胆红素血症对预测 NDI 的 Youden 指数值最高。基于本研究的结果,我们可以得出结论,在 18 个月校正年龄时,LPI-34 和 LPI-35 的神经发育结局无显著差异。患有严重高胆红素血症和/或 IVH 的患者应被视为发生 NDI 的高风险人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/819b/7828522/8a676b634a91/ijerph-18-00640-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/819b/7828522/8a676b634a91/ijerph-18-00640-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/819b/7828522/8a676b634a91/ijerph-18-00640-g001.jpg

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