Institute of Social Paediatrics and Adolescent Medicine, Division of Paediatric Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany.
Department of Neonatology, University Children's Hospital and Perinatal Centre, Ludwig-Maximilians-University Munich, Munich, Germany.
Dev Med Child Neurol. 2021 Jun;63(6):697-704. doi: 10.1111/dmcn.14816. Epub 2021 Jan 27.
To describe the incidence of term and preterm neonatal cerebral sinovenous thrombosis (CSVT) and identify perinatal risk factors.
This was a national capture-recapture calculation-corrected surveillance and nested case-control study. Infants born preterm and at term with magnetic resonance imaging-confirmed neonatal CSVT were identified by surveillance in all paediatric hospitals in Germany (2015-2017). Incidence was corrected for underreporting using a capture-recapture method in one federal state and then extrapolated nationwide. We reviewed PubMed for comparisons with previously reported incidence estimators. We used a population-based perinatal database for quality assurance to select four controls per case and applied univariate and multivariable regression for risk factor analysis.
Fifty-one newborn infants (34 males, 17 females; 14 born preterm) with neonatal CSVT were reported in the 3-year period. The incidence of term and preterm neonatal CSVT was 6.6 (95% confidence interval [CI] 4.4-8.7) per 100 000 live births. Median age at time of confirmation of the diagnosis was 9.95 days (range 0-39d). In the univariate analysis, male sex, preterm birth, hypoxia and related indicators (umbilical artery pH <7.1; 5-minute Apgar score <7; intubation/mask ventilation; perinatal asphyxia), operative vaginal delivery, emergency Caesarean section, and pathological fetal Doppler sonography were associated (p<0.05) with neonatal CSVT. Multivariable regression yielded hypoxia (odds ratio=20.3; 95% CI 8.1-50.8) as the independent risk factor.
Incidence of neonatal CSVT was within the range of other population-based studies. The results suggest that hypoxia is an important perinatal risk factor for the aetiology of neonatal CSVT.
描述足月和早产新生儿脑静脉窦血栓形成（CSVT）的发生率，并确定围产期危险因素。
这是一项全国性的捕获-再捕获校正监测和巢式病例对照研究。通过在德国所有儿科医院进行监测，发现经磁共振成像（MRI）证实患有新生儿 CSVT 的早产儿和足月儿。在一个联邦州使用捕获-再捕获方法对报告不足进行校正后，对发病率进行了校正，然后在全国范围内进行了外推。我们在 PubMed 上进行了检索，以与以前报告的发病率估计值进行比较。我们使用基于人群的围产期数据库进行质量保证，为每个病例选择 4 个对照，并应用单变量和多变量回归进行危险因素分析。
在 3 年期间报告了 51 例新生儿 CSVT（34 例男性，17 例女性；14 例早产儿）。足月和早产新生儿 CSVT 的发生率分别为每 100 000 例活产儿 6.6（95%置信区间 [CI] 4.4-8.7）。确诊时的中位年龄为 9.95 天（范围 0-39d）。在单变量分析中，男性、早产、缺氧及相关指标（脐动脉 pH 值<7.1；5 分钟 Apgar 评分<7；气管插管/面罩通气；围产期窒息）、阴道助产、紧急剖宫产术和胎儿多普勒超声异常与新生儿 CSVT 相关（p<0.05）。多变量回归得出缺氧（优势比=20.3；95%CI 8.1-50.8）是独立的危险因素。
新生儿 CSVT 的发生率在其他基于人群的研究范围内。结果表明，缺氧是新生儿 CSVT 病因的一个重要围产期危险因素。
