Department of Obstetrics and Gynaecology, Santo Stefano Hospital, Prato, 59100 USL Toscana Centro, Italy.
Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Genes (Basel). 2021 Apr 15;12(4):573. doi: 10.3390/genes12040573.
Intracranial hemorrhage (ICH) is reported in premature infants and rarely, in prenatal life. Fetal ICH can be accurately identified in utero and categorized by antenatal sonography and/or MRI. Infectious disease, maternal drug exposure, alloimmune thrombocytopenia, maternal trauma, coagulation disorders and twin-to-twin transfusion syndrome can cause fetal ICH. However, in many cases, the cause is not identified and a genetic disorder should be taken into consideration. We conducted a review of the literature to investigate what we know about genetic origins of fetal ICH. We conducted targeted research on the databases PubMed and EMBASE, ranging from 1980 to 2020. We found 311 studies and 290 articles were excluded because they did not meet the inclusion criteria, and finally, 21 articles were considered relevant for this review. Hemostatic, protrombotic, collagen and X-linked GATA 1 genes were reported in the literature as causes of fetal ICH. In cases of ICH classified as idiopathic, possible underlying genetic causes should be accounted for and investigated. The identification of ICH genetic causes can guide the counselling process with respect to the recurrence risk, in addition to producing relevant clinical data to the neonatologist for the optimal management and prompt treatment of the newborn.
颅内出血 (ICH) 在早产儿中较为常见,而在产前则很少见。胎儿 ICH 可通过产前超声和/或 MRI 准确识别,并进行分类。感染性疾病、母体药物暴露、同种免疫性血小板减少症、母体创伤、凝血障碍和双胎输血综合征均可导致胎儿 ICH。然而,在许多情况下,病因并不明确,应考虑遗传疾病。我们对文献进行了综述,以探讨我们对胎儿 ICH 的遗传起源的了解。我们在 PubMed 和 EMBASE 数据库中进行了有针对性的研究,范围从 1980 年到 2020 年。我们发现了 311 项研究,其中 290 篇文章因不符合纳入标准而被排除,最终有 21 篇文章被认为与本综述相关。文献中报道了止血、促血栓形成、胶原和 X 连锁 GATA1 基因是导致胎儿 ICH 的原因。对于分类为特发性 ICH 的病例,应考虑并调查可能存在的潜在遗传原因。ICH 遗传病因的确定可以指导咨询过程中的复发风险,此外还可以为新生儿科医生提供相关的临床数据,以便对新生儿进行最佳管理和及时治疗。