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早产儿(胎龄小于 28 周)的小脑损伤。

Cerebellar injury in preterm infants less than 28 weeks gestational age.

机构信息

Department of Obstetrics and Neonatology, Funabashi Central Hospital, Funabashi, Chiba, Japan.

Department of Radiology, Funabashi Central Hospital, Funabashi, Chiba, Japan.

出版信息

Pediatr Int. 2024 Jan-Dec;66(1):e15734. doi: 10.1111/ped.15734.

DOI:10.1111/ped.15734
PMID:38156509
Abstract

BACKGROUND

Cerebellar injury is one of the perinatal complications in preterm infants. Recent studies have highlighted the effect of perinatal complications on neurological morbidity. We investigated the perinatal risk factors and morbidity for cerebellar injury in extremely premature infants.

METHODS

This retrospective cohort study included 285 infants born between April 2009 and December 2020 at gestational age <28 weeks at our institution. The infants were divided into two groups based on magnetic resonance imaging findings: those with and without cerebellar injury. We performed a statistical analysis of the perinatal background and short-term morbidity of the two groups.

RESULTS

Significant differences (p < 0.05) were observed between the groups with respect to the perinatal background, especially gestational weeks, birthweight, and hemoglobin values at birth. In the short-term morbidity, significant differences (p < 0.05) were observed in the incidence of respiratory distress syndrome, chronic lung disease, hydrocephalus, severe intraventricular hemorrhage (IVH), and cerebellar hemorrhage. Extensive cerebellar lesions, such as cerebellar agenesis or global cerebellar hypoplasia, accounted for 11 of the 22 cases of cerebellar injury; seven of the 11 cases had severe IVH in addition to cerebellar hemorrhage.

CONCLUSIONS

Gestational age was significantly lower in the cerebellar injury group. The combination of severe IVH and cerebellar hemorrhage may promote cerebellar injury.

摘要

背景

小脑损伤是早产儿围产期并发症之一。近期研究强调了围产期并发症对神经发育不良的影响。我们调查了极早产儿小脑损伤的围产期危险因素和发病率。

方法

本回顾性队列研究纳入了 2009 年 4 月至 2020 年 12 月在我院出生、胎龄<28 周的 285 名婴儿。根据磁共振成像结果将婴儿分为两组:有小脑损伤组和无小脑损伤组。我们对两组的围产期背景和短期发病率进行了统计学分析。

结果

两组间的围产期背景存在显著差异(p<0.05),特别是胎龄、出生体重和出生时血红蛋白值。在短期发病率方面,呼吸窘迫综合征、慢性肺病、脑积水、重度脑室出血(IVH)和小脑出血的发生率存在显著差异(p<0.05)。广泛的小脑病变,如小脑发育不全或全小脑发育不良,占 22 例小脑损伤中的 11 例;11 例中有 7 例除了小脑出血外还有重度 IVH。

结论

小脑损伤组的胎龄明显较低。严重 IVH 与小脑出血的结合可能会促进小脑损伤。

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