在评估极早产儿发育结果时使用术语参考婴儿：一项多中心研究中的经验教训。
Use of term reference infants in assessing the developmental outcome of extremely preterm infants: lessons learned in a multicenter study.
机构信息
Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
J Perinatol. 2023 Nov;43(11):1398-1405. doi: 10.1038/s41372-023-01729-x. Epub 2023 Aug 4.
OBJECTIVE
Extremely preterm (EP) impairment rates are likely underestimated using the Bayley III norm-based thresholds scores and may be better assessed relative to concurrent healthy term reference (TR) infants born in the same hospital.
STUDY DESIGN
Blinded, certified examiners in the Neonatal Research Network (NRN) evaluated EP survivors and a sample of healthy TR infants recruited near the 2-year assessment age.
RESULTS
We assessed 1452 EP infants and 183 TR infants. TR-based thresholds showed higher overall EP impairment than Bayley norm-based thresholds (O.R. = 1.86; [95% CI 1.56-2.23], especially for severe impairment (36% vs. 24%; p ≤ 0.001). Difficulty recruiting TR patients at 2 years extended the study by 14 months and affected their demographics.
CONCLUSION
Impairment rates among EP infants appear to be substantially underestimated from Bayley III norms. These rates may be best assessed by comparison with healthy term infants followed with minimal attrition from birth in the same centers.
GOV ID
Term Reference (under the Generic Database Study): NCT00063063.
目的
使用贝利 III 基于标准的评分阈值，极早产儿（EP）的损伤率可能被低估，而与在同一家医院出生的同期健康足月参照（TR）婴儿相比，可能会更好地评估。
研究设计
新生儿研究网络（NRN）的经过认证的盲审员评估了 EP 幸存者和在接近 2 岁评估年龄时招募的健康 TR 婴儿的样本。
结果
我们评估了 1452 名 EP 婴儿和 183 名 TR 婴儿。基于 TR 的阈值显示，与贝利标准阈值相比，整体 EP 损伤程度更高（OR=1.86；[95%CI 1.56-2.23]），尤其是严重损伤（36% vs. 24%；p≤0.001）。在 2 岁时招募 TR 患者的困难使研究延长了 14 个月，并影响了他们的人口统计学特征。
结论
从贝利 III 标准来看，EP 婴儿的损伤率似乎被大大低估了。这些比率可能通过与在同一中心从出生开始最小流失的健康足月婴儿进行比较来最好地评估。
GOV ID
Term Reference（在 Generic Database Study 下）：NCT00063063。
Zotero 插件