Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.
Department of Neonatology, the Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel- Aviv University, Tel- Aviv, Israel.
Eur J Obstet Gynecol Reprod Biol. 2022 Mar;270:6-10. doi: 10.1016/j.ejogrb.2021.12.036. Epub 2021 Dec 31.
Preeclampsia during pregnancy is associated with an increased risk for various neonatal morbidities. We aimed to investigate the association between prematurity due to maternal preeclampsia and developmental outcomes.
This retrospective matched case-control study included 39 preterm infants (<32 weeks gestation) born to preeclamptic mothers between 2012 and 2016, compared with 39 infants born to mothers without preeclampsia. The two groups were matched for gestational age (±1 week), gender and plurality. Neurodevelopmental outcome was assessed using the Griffith's Mental Developmental Scales at 6, 12 and 24 months corrected age.
The groups were comparable in terms of gestational age (30.2 weeks vs 29.8, P = 0.6), exposure to antenatal glucocorticosteroids and magnesium sulfate. The two groups differed significantly in birthweight so that cases had significantly lower birthweight, 1100 (IQR 844.5-1316.5) vs. 1370 (IQR 1174-1604.5) grams. 19/39 (48.7%) cases were small for gestational age compared with only 4/39 (10.3%) controls (P < 0.01). 16/39 of cases were born less than 1000 g, compared with only 5/39 controls (41% vs 12.8%, P < 0.01). Early complications were similar. Compared with controls, an overall trend for better neurodevelopmental performance on Griffith's score was found for cases, especially for early (6 months) non-motor performance. All severely disabled infants (Griffith's score < 55) at 24 months assessment were among controls.
Although significantly smaller and smaller for gestational age, neurodevelopmental assessment by Griffiths' Mental Development Scales was similar for cases and controls with a trend towards better performance of cases at 6 months. Further studies are needed to determine whether the trend for better performance implies a developmental advantage.
妊娠子痫前期与多种新生儿并发症的风险增加相关。我们旨在研究因母体子痫前期导致的早产与发育结局之间的关系。
本回顾性匹配病例对照研究纳入了 2012 年至 2016 年间 39 名因子痫前期而早产（<32 周）的婴儿，与 39 名非子痫前期母亲所生的婴儿进行比较。两组在孕龄（±1 周）、性别和多胎方面相匹配。神经发育结局采用 Griffith 精神发育量表在矫正年龄 6、12 和 24 个月时进行评估。
两组在孕龄（30.2 周与 29.8 周，P=0.6）、产前糖皮质激素和硫酸镁暴露方面具有可比性。两组的出生体重差异显著，病例组的出生体重显著较低，为 1100（IQR 844.5-1316.5）克，而对照组为 1370（IQR 1174-1604.5）克。19/39（48.7%）病例为小于胎龄儿，而对照组仅为 4/39（10.3%）（P<0.01）。16/39 例患儿出生体重<1000 克，而对照组仅 5/39（41%与 12.8%，P<0.01）。早期并发症相似。与对照组相比，病例组在 Griffith 评分上的神经发育表现总体呈较好趋势，尤其是在早期（6 个月）非运动表现上。24 个月评估时所有严重残疾婴儿（Griffith 评分<55）均来自对照组。
尽管病例组的婴儿明显更小且为小于胎龄儿，但通过 Griffith 精神发育量表进行的神经发育评估在病例组和对照组之间相似，且病例组在 6 个月时的表现呈更好趋势。需要进一步的研究来确定这种表现较好的趋势是否意味着存在发育优势。
