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先天性手术畸形婴儿的神经发育不良结局的生长和风险:系统评价。

Growth and risk of adverse neurodevelopmental outcome in infants with congenital surgical anomalies: a systematic review.

机构信息

Grace Centre for Newborn Intensive Care, Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, Australia.

Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

出版信息

Pediatr Surg Int. 2022 Nov 28;39(1):3. doi: 10.1007/s00383-022-05305-w.

Abstract

Survival of infants with congenital anomalies requiring surgical correction has increased dramatically, shifting the focus of clinical care and research toward optimising growth and neurodevelopment.To determine the impact of growth on neurodevelopmental outcomes of infants with congenital surgical anomalies. Studies that reported association of growth with developmental outcomes in infants with congenital anomalies who had surgery, were eligible for inclusion. The search strategy was prospectively drafted, and relevant studies were identified by electronic searches. The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2022, issue 1), MEDLINE and EMBASE from their earliest date to February 2022 were searched. Seven studies met the inclusion criteria. Variability in selection of growth measures, developmental assessment tools and assessment endpoints for neurodevelopment, precluded a meta-analysis. Four studies reported the association between growth and neurodevelopmental outcomes in infants with gastroschisis with two noting adverse outcomes in infants who were small for gestational age. Birthweight, reported in four studies, was not associated with adverse developmental outcomes. Postnatal growth, reported in three studies, was associated with adverse outcome. The data linking growth restriction in infants with congenital surgical anomalies and neurodevelopmental outcome is limited. There is limited published research examining the longitudinal effects of intra- and extra-uterine growth parameters on neurodevelopmental outcomes.

摘要

患有需要手术矫正的先天性畸形的婴儿的存活率显著提高,这将临床护理和研究的重点转移到优化生长和神经发育上。为了确定生长对先天性手术畸形婴儿神经发育结果的影响。我们纳入了报道了生长与接受手术的先天性畸形婴儿发育结果之间关联的研究。检索策略是前瞻性制定的,并通过电子检索确定了相关研究。对 Cochrane 中央对照试验注册库(CENTRAL,The Cochrane Library 2022 年第 1 期)、MEDLINE 和 EMBASE 进行了检索,检索时间从最早日期到 2022 年 2 月。有 7 项研究符合纳入标准。生长测量、发育评估工具和神经发育评估终点的选择存在差异,因此无法进行荟萃分析。有 4 项研究报告了胃膨出婴儿的生长与神经发育结果之间的关联,其中有 2 项研究注意到小于胎龄儿的不良结局。4 项研究报告了出生体重与不良发育结局之间无关联。3 项研究报告了出生后的生长与不良结局相关。将先天性手术畸形婴儿的生长受限与神经发育结果联系起来的数据有限。目前发表的研究很少,研究宫内和宫外生长参数对神经发育结果的纵向影响。

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