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妊娠34周前出生的儿童,子痫前期合并母体肾功能不全与3岁时神经发育不良有关。

Pre-eclampsia Complicated With Maternal Renal Dysfunction Is Associated With Poor Neurological Development at 3 Years Old in Children Born Before 34 Weeks of Gestation.

作者信息

Yoneda Noriko, Yoneda Satoshi, Tsuda Sayaka, Ito Mika, Shiozaki Arihiro, Niimi Hideki, Yoshida Taketoshi, Nakashima Akitoshi, Saito Shigeru

机构信息

Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.

Clinical Laboratory Center, Toyama University Hospital, Toyama, Japan.

出版信息

Front Pediatr. 2021 Apr 29;9:624323. doi: 10.3389/fped.2021.624323. eCollection 2021.

Abstract

The purpose of this study was to investigate perinatal factors associated with a poor neurodevelopmental outcome in preterm infants. A retrospective study was conducted by searching our clinical database between January 2006 and December 2016. A total of 165 singleton children who were born between 23 and 33 weeks of gestation were included. We defined poor neurological development outcomes as follows: cerebral palsy; intellectual disability; developmental disorder including autism and attention-deficit/hyperactivity disorder; low score (<85 points) on Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III); or low score of Kyoto Scale of Psychological Development corrected at 3 years old. We diagnosed maternal renal dysfunction according to the Clinical Practice Guideline for chronic kidney disease 2018 and the Best Practice Guide 2015 for Care and Treatment of Hypertension in Pregnancy. The rate of poor neurological development was 25/165 (15.2%): cerebral palsy ( = 1), intellectual disability ( = 1), developmental disorder ( = 2), low score of Bayley-III ( = 20), and low score of Kyoto Scale of Psychological Development ( = 1). Preeclampsia complicated with maternal renal dysfunction ( = 0.045) and delivery at <30 weeks of gestation ( = 0.007) were independent risk factors for poor neurological development. In addition to previous risk factors such as delivery at <30 weeks of gestation, preeclampsia complicated with renal dysfunction was also associated with poor neurodevelopmental outcomes corrected at 3 years old.

摘要

本研究的目的是调查与早产儿神经发育不良结局相关的围产期因素。通过检索我们2006年1月至2016年12月期间的临床数据库进行了一项回顾性研究。共纳入165例孕23至33周出生的单胎儿童。我们将不良神经发育结局定义如下:脑瘫;智力残疾;包括自闭症和注意力缺陷/多动障碍在内的发育障碍;贝利婴幼儿发育量表第三版(Bayley-III)得分低(<85分);或3岁时京都心理发育量表得分低。我们根据《2018年慢性肾脏病临床实践指南》和《2015年妊娠高血压护理与治疗最佳实践指南》诊断孕妇肾功能不全。神经发育不良的发生率为25/165(15.2%):脑瘫(=1)、智力残疾(=1)、发育障碍(=2)、Bayley-III得分低(=20)、京都心理发育量表得分低(=1)。子痫前期合并孕妇肾功能不全(=0.045)和妊娠<30周分娩(=0.007)是神经发育不良的独立危险因素。除了妊娠<30周分娩等既往危险因素外,子痫前期合并肾功能不全也与3岁时校正后的神经发育不良结局相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fb8/8116540/6e0bad456bf5/fped-09-624323-g0001.jpg

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