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围产期缺氧和窒息在早期学龄期的长期结局。

Long-Term Outcomes of Perinatal Hypoxia and Asphyxia at an Early School Age.

机构信息

Department of Neonatology, Lithuanian University of Health Sciences, LT-50009 Kaunas, Lithuania.

Department of Radiology, Lithuanian University of Health Sciences, LT-50009 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2021 Sep 18;57(9):988. doi: 10.3390/medicina57090988.

Abstract

Late long-term outcomes of perinatal asphyxia (PA) in school-age are often unclear. To assess long-term outcomes at an early school age in children who had experienced perinatal hypoxia or asphyxia, where therapeutic hypothermia was not applied. : The case group children were 8-9-year-old children ( = 32) who were born at full term and experienced hypoxia or asphyxia at birth, where therapeutic hypothermia (TH) was not applied. The control group consisted of 8-9-year-old children ( = 16) born without hypoxia. A structured neurological examination was performed at an early school age. The neuromotor function was assessed using the Gross Motor Function Classification System (GMFCS). Health-related quality-of-life was assessed using the Health Utilities Index (HUI) questionnaire. Intellectual abilities were assessed using the Wechsler Intelligence Scale for Children (WISC). The case group, compared with controls, had significantly ( = 0.002) lower mean [SD] full-scale IQ (87(16.86) vs. 107(12.15)), verbal-scale IQ (89(17.45) vs. 105(11.55)), verbal comprehension index (89(17.36) vs. 105(10.74)), working memory index (89(15.68) vs. 104(11.84)), performance IQ (87(16.51) vs. 108(15.48)) and perceptual organization index (85(15.71) vs. 105(15.93)). We did not find any significant differences in the incidence of disorders of neurological examination, movement abilities and health-related quality of life at an early school age between the case and the control group children. In children who experienced perinatal asphyxia but did not have cerebral paralysis (CP), where therapeutic hypothermia was not applied, cognitive assessment scores at an early school age were significantly lower compared to those in the group of healthy children, and were at a low average level.

摘要

围产期窒息(PA)患儿在学龄期的长期预后往往不明确。本研究旨在评估未应用治疗性低温的围生期缺氧或窒息患儿在早期学龄期的长期预后。病例组为 8-9 岁(n = 32)足月出生且有围生期缺氧或窒息但未应用治疗性低温的患儿;对照组为 8-9 岁(n = 16)无缺氧出生的患儿。所有患儿在早期学龄期均进行了结构化的神经检查,使用粗大运动功能分类系统(GMFCS)评估神经运动功能,使用健康效用指数(HUI)问卷评估健康相关生活质量,使用韦氏儿童智力量表(WISC)评估智力能力。与对照组相比,病例组患儿的平均[标准差]总智商(FIQ)(87(16.86)vs. 107(12.15))、言语智商(VIQ)(89(17.45)vs. 105(11.55))、言语理解指数(VCI)(89(17.36)vs. 105(10.74))、工作记忆指数(WMI)(89(15.68)vs. 104(11.84))、操作智商(PIQ)(87(16.51)vs. 108(15.48))和知觉组织指数(POI)(85(15.71)vs. 105(15.93))均显著降低(P = 0.002)。在早期学龄期,病例组和对照组患儿的神经检查、运动能力和健康相关生活质量障碍的发生率均无显著差异。在未发生脑瘫(CP)但未应用治疗性低温的围生期窒息患儿中,其在早期学龄期的认知评估得分明显低于健康儿童,且处于较低的平均水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0116/8466311/3033dd8bc642/medicina-57-00988-g001.jpg

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