Chen Huiling, Bai Peng, Yang Shuqi, Jia Mingzhu, Tian Huan, Zou Juan, Xiao Xue
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China.
Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
J Clin Med. 2023 Jan 30;12(3):1065. doi: 10.3390/jcm12031065.
Birth defects have brought about major public health problems, and studying the clinical outcomes of the most common prenatal central nervous system abnormality, namely, fetal ventriculomegaly (VM), is helpful for improving reproductive health and fertility quality. This is a retrospective cohort study from 2011 to 2020 in the West China Second University Hospital, Sichuan University, aiming to evaluate the short-term and long-term outcomes of VM over 37 weeks' gestation to exclude the influence of preterm birth. The study analyzed data from 401 term pregnancies, with 179 VM and 222 controls. From the short-term outcomes, the rate of the neonatal intensive care unit (NICU) admission under the VM group (10.06%) was comparatively higher than the control (0.45%), but Apgar scores between both groups at 1 min, 5 min and 10 min were not significantly different. From the long-term outcomes, there were more infants with abnormal neurodevelopment under the VM group than control (14.53% vs. 2.25%, < 0.001). In addition, NICU admission ( = 0.006), peak width of lateral ventricles ( = 0.030) and postnatal cranial ultrasound suggestive with VM ( = 0.002) were related to infants' long-term outcomes. NICU admission during the perinatal period was an independent risk factor for the adverse long-term outcomes (OR = 3.561, 95% CI 1.029-12.320, = 0.045). In conclusion, VM impairs short-term and long-term outcomes of term infants. Short-term outcome, especially NICU admission, could predict their adverse long-term outcomes.
出生缺陷已引发重大公共卫生问题，研究最常见的产前中枢神经系统异常即胎儿脑室扩大（VM）的临床结局，有助于改善生殖健康和生育质量。这是一项于2011年至2020年在四川大学华西第二医院开展的回顾性队列研究，旨在评估妊娠37周以上VM的短期和长期结局，以排除早产的影响。该研究分析了401例足月妊娠的数据，其中179例为VM，222例为对照。就短期结局而言，VM组新生儿重症监护病房（NICU）收治率（10.06%）相对高于对照组（0.45%），但两组在1分钟、5分钟和10分钟时的阿氏评分无显著差异。就长期结局而言，VM组神经发育异常的婴儿多于对照组（14.53%对2.25%，<0.001）。此外，NICU收治（P = 0.006）、侧脑室峰值宽度（P = 0.030）和产后头颅超声提示VM（P = 0.002）与婴儿的长期结局相关。围产期NICU收治是不良长期结局的独立危险因素（OR = 3.561，95%CI 1.029 - 12.320，P = 0.045）。总之，VM会损害足月婴儿的短期和长期结局。短期结局，尤其是NICU收治情况，可预测其不良长期结局。
