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光疗与发育迟缓风险:日本环境与儿童研究。

Phototherapy and risk of developmental delay: the Japan Environment and Children's Study.

机构信息

Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.

Maternal & Child Health Information Center, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.

出版信息

Eur J Pediatr. 2023 May;182(5):2139-2149. doi: 10.1007/s00431-022-04785-1. Epub 2023 Feb 27.

Abstract

UNLABELLED

This observational cohort study aimed to examine the association between the duration of phototherapy for neonatal jaundice and the risk of developmental delay at 3 years of age using nationwide birth cohort data. Data from 76,897 infants were analyzed. We divided participants into four groups: no phototherapy, short phototherapy (1-24 h), long phototherapy (25-48 h), and very long phototherapy (> 48 h). The Japanese version of the Ages and Stages Questionnaire-3 was used to evaluate the risk of developmental delay at 3 years of age. Logistic regression analysis was performed to assess the impact of phototherapy duration on the prevalence of developmental delay. After adjustment for potential risk factors, a dose-response relationship was identified between the duration of phototherapy and Ages and Stages Questionnaire-3, and the differences were significant in four domains; odds ratio for communication delay was associated with short, long, and very long phototherapy = 1.10 (95% confidence interval 0.97-1.26), 1.32 (1.04-2.66), and 1.48 (1.11-1.98), respectively; for gross motor delay = 1.01 (0.89-1.15), 1.28 (1.03-2.58), and 1.26 (0.96-1.67); for problem solving delay = 1.13 (1.03-1.25), 1.19 (0.99-1.43), and 1.41 (1.11-1.79); and for personal social delay = 1.15 (0.99-1.32), 1.10 (0.84-1.44), and 1.84 (1.38-2.45).

CONCLUSION

Longer duration of phototherapy is a predictive factor for developmental delay, making it important to avoid extended periods of phototherapy. However, whether it increases the prevalence of developmental delay remains unclear.

WHAT IS KNOWN

• Phototherapy is a common treatment for neonatal jaundice, associated with both short-term and long-term complications. • However, an association between phototherapy and the prevalence of developmental delay has not been revealed in a large cohort study.

WHAT IS NEW

• We identified that a long duration of phototherapy was a predictive factor for developmental delay at 3 years of age. • However, whether a long duration of phototherapy increases the prevalence of developmental delay remains unclear.

摘要

目的

本观察性队列研究旨在利用全国性出生队列数据,探讨新生儿黄疸光疗持续时间与 3 岁时发育迟缓风险之间的关联。

方法

使用全国性出生队列数据,分析了 76897 名婴儿的数据。我们将参与者分为四组:无光疗、短时间光疗(1-24 小时)、长时间光疗(25-48 小时)和超长时间光疗(>48 小时)。使用日本版年龄与阶段问卷-3 评估 3 岁时发育迟缓的风险。采用 logistic 回归分析评估光疗持续时间对发育迟缓患病率的影响。在调整了潜在的危险因素后,我们发现光疗持续时间与年龄和阶段问卷之间存在剂量-反应关系,并且在四个领域存在显著差异;沟通延迟的优势比与短、长和超长光疗相关分别为 1.10(95%置信区间 0.97-1.26)、1.32(1.04-2.66)和 1.48(1.11-1.98);粗大运动延迟分别为 1.01(0.89-1.15)、1.28(1.03-2.58)和 1.26(0.96-1.67);解决问题的延迟分别为 1.13(1.03-1.25)、1.19(0.99-1.43)和 1.41(1.11-1.79);个人社会延迟分别为 1.15(0.99-1.32)、1.10(0.84-1.44)和 1.84(1.38-2.45)。

结论

较长的光疗持续时间是发育迟缓的预测因素,因此重要的是避免延长光疗时间。然而,光疗持续时间延长是否会增加发育迟缓的患病率尚不清楚。

需要注意的是,以上译文仅为示例,可能存在不够准确或自然的地方。具体的翻译质量还需要根据实际情况进行评估和调整。

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