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孕期疑似早产对儿童期心脏代谢状况和神经发育的影响:一项前瞻性队列研究方案

Impact of Suspected Preterm Labor during Pregnancy on Cardiometabolic Profile and Neurodevelopment during Childhood: A Prospective Cohort Study Protocol.

作者信息

González Jesús, Vilella Marina, Ruiz Sonia, Iglesia Iris, Clavero-Adell Marcos, Ayerza-Casas Ariadna, Matute-Llorente Angel, Oros Daniel, Casajús Jose Antonio, Pueyo Victoria, Rodriguez Gerardo, Paules Cristina

机构信息

Pediatrics Department, Quirónsalud Hospital Zaragoza, 50006 Zaragoza, Spain.

Instituto de Investigación Sanitaria Aragón (IIS Aragon), 50009 Zaragoza, Spain.

出版信息

Diagnostics (Basel). 2023 Mar 14;13(6):1101. doi: 10.3390/diagnostics13061101.

Abstract

INTRODUCTION

Suspected preterm labor (SPL), defined as the presence of regular and painful uterine contractions and cervical shortening, represents a prenatal insult with potential long-term consequences. However, despite recent evidence demonstrating suboptimal neurodevelopment at 2 years in this population, it remains underestimated as a significant risk factor for neurodevelopmental disorders or other chronic diseases. The aim of this study is to assess the impact of suspected preterm labor during pregnancy on cardiometabolic profile and neurodevelopment during childhood (6-8 years).

METHODS AND ANALYSIS

Prospective cohort study including children whose mothers suffered suspected preterm labour during pregnancy and paired controls. Neurodevelopmental, cardiovascular, and metabolic assessments will be performed at 6-8 years of age. A trained psychologist will carry out the neurodevelopment assessment including intelligence, visual perception, and behavioral assessment. Body composition and physical fitness assessment will be performed by one trained pediatrician and nurse. Finally, cardiovascular evaluation, including echocardiography and blood pressure, will be performed by two pediatric cardiologists. Data regarding perinatal and postnatal characteristics, diet, lifestyle, and weekly screen time of the child will be obtained from medical history and direct interviews with families. Primary outcome measures will include body mass index and adiposity, percentage of fat mass and total and regional lean mass, bone mineral content and density, cardiorespiratory resistance, isometric muscle strength, dynamic lower body strength, systolic and diastolic blood pressure, left ventricle (LV) systolic and diastolic function, general intelligence index, visuospatial working memory span, oculomotor control test, index of emotional, and behavioral problems.

摘要

引言

疑似早产(SPL)定义为出现规律且疼痛的子宫收缩以及宫颈缩短,是一种具有潜在长期后果的产前损伤。然而,尽管近期有证据表明该人群在2岁时神经发育欠佳,但作为神经发育障碍或其他慢性疾病的重要风险因素,它仍未得到充分重视。本研究的目的是评估孕期疑似早产对儿童期(6 - 8岁)心脏代谢状况和神经发育的影响。

方法与分析

前瞻性队列研究,纳入孕期母亲患有疑似早产的儿童及其配对对照。将在儿童6 - 8岁时进行神经发育、心血管和代谢评估。一名经过培训的心理学家将进行神经发育评估,包括智力、视觉感知和行为评估。身体成分和体能评估将由一名经过培训的儿科医生和护士进行。最后,两名儿科心脏病专家将进行心血管评估,包括超声心动图和血压测量。有关围产期和产后特征、儿童饮食、生活方式及每周屏幕使用时间的数据将从病史记录以及与家庭的直接访谈中获取。主要结局指标将包括体重指数和肥胖程度、脂肪量百分比以及全身和局部瘦体重、骨矿物质含量和密度、心肺耐力、等长肌肉力量、下肢动态力量、收缩压和舒张压、左心室(LV)收缩和舒张功能、一般智力指数、视觉空间工作记忆广度、动眼控制测试、情绪指数和行为问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bd2/10047113/fe09aae31356/diagnostics-13-01101-g001.jpg

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