早产儿出血后脑室扩大的流行病学。
Epidemiology of post-hemorrhagic ventricular dilatation in very preterm infants.
机构信息
Department of Pediatrics, IWK Health Centre and Dalhousie University, Halifax, NS, Canada.
Maternal-infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada.
出版信息
J Perinatol. 2022 Oct;42(10):1392-1399. doi: 10.1038/s41372-022-01483-6. Epub 2022 Aug 9.
OBJECTIVE
To describe the incidence, trends, management's variability and short-term outcomes of preterm infants with severe post-hemorrhagic ventricular dilatation (sPHVD).
METHODS
We reviewed infants <33 weeks' gestation who had PHVD and were admitted to the Canadian Neonatal Network between 2010 and 2018. We compared perinatal characteristics and short-term outcomes between those with sPHVD and those with mild/moderate PHVD and those with and without ventriculo-peritoneal (VP) shunt.
RESULTS
Of 29,417 infants, 2439 (8%) had PHVD; rate increased from 7.3% in 2010 to 9.6% in 2018 (P = 0.005). Among infants with PHVD, sPHVD (19%) and VP shunt (29%) rates varied significantly across Canadian centers and between geographic regions (P < 0.01 and P = 0.0002). On multivariable analysis, sPHVD was associated with greater mortality, seizures and meningitis compared to mild/moderate PHVD.
CONCLUSIONS
Significant variability in sPHVD and VP shunt rates exists between centers and regions in Canada. sPHVD was associated with increased mortality and morbidities.
目的
描述严重出血后脑室扩张（sPHVD）早产儿的发病率、趋势、管理变异性和短期结局。
方法
我们回顾了 2010 年至 2018 年间在加拿大新生儿网络中患有 PHVD 且胎龄<33 周的婴儿。我们比较了 sPHVD 与轻度/中度 PHVD 以及有和无脑室-腹膜（VP）分流的围产期特征和短期结局。
结果
在 29417 名婴儿中，有 2439 名（8%）患有 PHVD；发病率从 2010 年的 7.3%增加到 2018 年的 9.6%（P=0.005）。在患有 PHVD 的婴儿中，sPHVD（19%）和 VP 分流（29%）的比率在加拿大各中心和地理区域之间存在显著差异（P < 0.01 和 P = 0.0002）。多变量分析显示，与轻度/中度 PHVD 相比，sPHVD 与更高的死亡率、癫痫发作和脑膜炎相关。
结论
加拿大各中心和地区之间在 sPHVD 和 VP 分流率方面存在显著差异。sPHVD 与死亡率和发病率增加有关。
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