颅内超声异常与胎儿多普勒研究结果分层的胎儿生长受限与非胎儿生长受限早产儿的死亡率。
Intracranial ultrasound abnormalities and mortality in preterm infants with and without fetal growth restriction stratified by fetal Doppler study results.
机构信息
Division of Neonatology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, New York, NY, USA.
出版信息
J Perinatol. 2023 May;43(5):560-567. doi: 10.1038/s41372-023-01621-8. Epub 2023 Jan 30.
OBJECTIVE
To evaluate whether fetal growth restriction (FGR) with or without abnormal Dopplers is associated with intracranial abnormalities and death in premature infants.
STUDY DESIGN
Premature infants with and without FGR born between 2016 and 2019 were included. Primary outcome was death, severe intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL). Groups were compared using standard bivariate testing and multivariable regression.
RESULTS
Among 168 FGR and 560 non-FGR infants, FGR infants with abnormal Dopplers had an increased incidence of death, severe IVH or PVL compared to non-FGR infants (13% (16/123) vs. 7% (41/560); p = 0.03) while FGR infants with normal Dopplers had a nonsignificant decrease. In a logistic regression model, FGR with abnormal Dopplers was associated with more than three times higher odds of death, severe IVH or PVL (OR 3.2, 95% CI 1.54,6.49; p < 0.001).
CONCLUSIONS
Growth-restricted infants with abnormal Dopplers had an increased risk of death, intracranial abnormalities, and prematurity-related morbidities.
目的
评估胎儿生长受限（FGR）伴或不伴异常多普勒是否与早产儿颅内异常和死亡有关。
研究设计
纳入 2016 年至 2019 年间出生的有或无 FGR 的早产儿。主要结局为死亡、严重脑室周围出血（IVH）或脑室周围白质软化（PVL）。采用标准双变量检验和多变量回归比较各组。
结果
在 168 例 FGR 婴儿和 560 例非 FGR 婴儿中，FGR 伴异常多普勒的婴儿与非 FGR 婴儿相比，死亡、严重 IVH 或 PVL 的发生率增加（13%（16/123）比 7%（41/560）；p=0.03），而 FGR 伴正常多普勒的婴儿发生率无显著下降。在逻辑回归模型中，FGR 伴异常多普勒与死亡、严重 IVH 或 PVL 的发生风险增加三倍以上相关（OR 3.2，95%CI 1.54，6.49；p<0.001）。
结论
伴有异常多普勒的生长受限婴儿死亡、颅内异常和与早产相关的发病率风险增加。
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