29 周以下胎龄的单胎巨大儿的神经发育结局：一项回顾性队列研究。
Neurodevelopmental outcomes of singleton large for gestational age infants <29 weeks' gestation: a retrospective cohort study.
机构信息
Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada.
Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver, Canada.
出版信息
J Perinatol. 2021 Jun;41(6):1313-1321. doi: 10.1038/s41372-021-01080-z. Epub 2021 May 25.
OBJECTIVE
To compare neurodevelopmental outcomes of large and appropriate for gestational age (LGA, AGA) infants <29 weeks' gestation at 18-24 months of corrected age.
STUDY DESIGN
Retrospective cohort study using the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network databases. Primary outcome was a composite of death or significant neurodevelopmental impairment (NDI), defined as severe cerebral palsy, Bayley III cognitive, language and motor scores of <70, need for hearing aids or cochlear implant and bilateral visual impairment. Univariate and multivariable logistic analyses were applied for outcomes.
RESULTS
The study cohort comprised 170 LGA and 1738 AGA infants. There was no difference in significant NDI or individual components of the Bayley III between LGA and AGA groups. LGA was associated with the increased risk of death by follow-up, 44/170 (25.9%) vs. 320/1738 (18.4%) (aOR: 1.60 95% CI: 1.00-2.54).
CONCLUSIONS
Risk of NDI was similar between LGA and AGA infants.
目的
比较<29 孕周且出生体重大于或等于相应胎龄（LGA、AGA）的婴儿在 18-24 个月校正年龄时的神经发育结局。
研究设计
回顾性队列研究，使用加拿大新生儿网络和加拿大新生儿随访网络数据库。主要结局是死亡或严重神经发育障碍（NDI）的复合结局，定义为严重脑瘫、贝利 III 认知、语言和运动评分<70、需要助听器或人工耳蜗植入以及双侧视力障碍。采用单变量和多变量逻辑分析评估结局。
结果
研究队列包括 170 例 LGA 和 1738 例 AGA 婴儿。LGA 和 AGA 组之间在严重 NDI 或贝利 III 的各个组成部分方面没有差异。随访时 LGA 与死亡风险增加相关，44/170（25.9%）比 320/1738（18.4%）（aOR：1.60，95%CI：1.00-2.54）。
结论
LGA 和 AGA 婴儿的 NDI 风险相似。
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