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德国一家三级新生儿重症监护病房中极早产儿生长迟缓与发育缺陷的风险因素

Risk Factors of Growth Retardation and Developmental Deficits in Very Preterm Infants in a German Tertiary Neonatal Unit.

作者信息

Lademann Hanne, Janning Anna, Müller Josephyn, Neumann Luisa, Olbertz Dirk, Däbritz Jan

机构信息

Department of Pediatrics, Rostock University Medical Center, 18057 Rostock, Germany.

Medical School, Rostock University Medical Center, 18055 Rostock, Germany.

出版信息

Children (Basel). 2021 May 14;8(5):394. doi: 10.3390/children8050394.

Abstract

Over the last two decades, improvements in perinatology have led to increased survival rates of preterm infants. A large number of studies and meta-analyses have investigated of preterm infants and/or the influence of developmental care. However, the combined influence of the most frequent risk factors and developmental care on the long-term somatic, motor, and cognitive outcome of preterm infants remains unclear. This retrospective, single-center cohort study includes 256 children treated in a tertiary neonatal intensive care unit in Rostock, Germany, between 2008 and 2013. Follow-up examinations (somatic, psychomotor, and mental development) were performed at (corrected) 24 months using Bayley Scales of Infant Development II (BSID-II). Developmental care was carried out according to the legal framework and national guidelines (physiotherapy and/or early education). Bronchopulmonary dysplasia (BPD) and an exclusive formula feeding showed a 2.8-4.6-fold higher risk (95% Confidence Interval: Mental Developmental Index 1.73-7.58; Psychomotor Developmental Index 1.44-14.54; body length 1.20-6.41) for developmental deficits (mental and psychomotor developmental index; body length). Developmental care after discharge according to national guidelines did not prevent this. Since this is a retrospective pilot study, no recommendations can be made based on this analysis. Therefore, future research should evaluate whether standard developmental care should be extended by tailored measures depending on individual risk factors.

摘要

在过去二十年中,围产医学的进步使早产儿存活率提高。大量研究和荟萃分析调查了早产儿情况及/或发育照护的影响。然而,最常见风险因素与发育照护对早产儿长期躯体、运动和认知结局的综合影响仍不明确。这项回顾性单中心队列研究纳入了2008年至2013年间在德国罗斯托克一家三级新生儿重症监护病房接受治疗的256名儿童。在(矫正)24个月时使用贝利婴幼儿发展量表第二版(BSID-II)进行随访检查(躯体、心理运动和智力发育)。发育照护按照法律框架和国家指南(物理治疗和/或早期教育)实施。支气管肺发育不良(BPD)和单纯配方奶喂养显示发育缺陷(智力和心理运动发育指数;身长)风险高2.8至4.6倍(95%置信区间:智力发育指数1.73至7.58;心理运动发育指数1.44至14.54;身长1.20至6.41)。出院后按照国家指南进行的发育照护未能预防这种情况。由于这是一项回顾性试点研究,无法基于该分析提出建议。因此,未来研究应评估是否应根据个体风险因素通过量身定制的措施来扩展标准发育照护。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c935/8156291/c6646456a968/children-08-00394-g001.jpg

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