Musco Hannah, Beecher Kate, Chand Kirat K, Boyd Roslyn N, Colditz Paul B, Wixey Julie A
UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Front Pediatr. 2024 Jun 20;12:1396102. doi: 10.3389/fped.2024.1396102. eCollection 2024.
Fetal growth restriction (FGR) impacts 5%-10% of pregnancies and is associated with increased risk of mortality and morbidity. Although adverse neurodevelopmental outcomes are observed in up to 50% of FGR infants, a diagnosis of FGR does not indicate the level of risk for an individual infant and these infants are not routinely followed up to assess neurodevelopmental outcomes. Identifying FGR infants at increased risk of adverse neurodevelopmental outcomes would greatly assist in providing appropriate support and interventions earlier, resulting in improved outcomes. However, current methods to detect brain injury around the time of birth lack the sensitivity required to detect the more subtle alterations associated with FGR. Blood biomarkers have this potential. This systematic review assessed the current literature on blood biomarkers for identifying FGR infants at increased risk of adverse neurodevelopmental outcomes at >12 months after birth. Four databases were searched from inception to 22 February 2024. Articles were assessed for meeting the inclusion criteria by two reviewers. The quality of the included article was assessed using Quality Assessment of Diagnostic Accuracy Studies-2. A summary of findings is presented as insufficient articles were identified for meta-analysis. Excluding duplicates, 1,368 records were screened with only 9 articles considered for full text review. Only one article met all the inclusion criteria. Quality assessment indicated low risk of bias. Both blood biomarkers investigated in this study, neuron specific enolase and S100B, demonstrated inverse relationships with neurodevelopmental assessments at 2 years. Four studies did not meet all the inclusion criteria yet identified promising findings for metabolites and cytokines which are discussed here. These findings support the need for further research and highlight the potential for blood biomarkers to predict adverse outcomes.
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369242, Identifier CRD42022369242.
胎儿生长受限（FGR）影响5%-10%的妊娠，且与死亡率和发病率增加相关。尽管高达50%的FGR婴儿会出现不良神经发育结局，但FGR的诊断并不表明单个婴儿的风险水平，并且这些婴儿未被常规随访以评估神经发育结局。识别出具有不良神经发育结局高风险的FGR婴儿将极大地有助于更早地提供适当的支持和干预，从而改善结局。然而，目前在出生时检测脑损伤的方法缺乏检测与FGR相关的更细微改变所需的敏感性。血液生物标志物具有这种潜力。本系统评价评估了关于血液生物标志物的现有文献，以识别出生后12个月以上具有不良神经发育结局高风险的FGR婴儿。从数据库创建至2024年2月22日检索了四个数据库。由两名评审员评估文章是否符合纳入标准。使用诊断准确性研究质量评估-2对纳入文章的质量进行评估。由于识别出的文章不足，无法进行荟萃分析，因此仅呈现了研究结果总结。排除重复项后，筛选了1368条记录，仅9篇文章被考虑进行全文评审。只有一篇文章符合所有纳入标准。质量评估表明偏倚风险较低。本研究中调查的两种血液生物标志物，神经元特异性烯醇化酶和S100B，在2岁时与神经发育评估均呈负相关。四项研究未符合所有纳入标准，但确定了有前景的代谢物和细胞因子研究结果，在此进行讨论。这些结果支持进一步研究的必要性，并突出了血液生物标志物预测不良结局的潜力。
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369242，标识符CRD42022369242 。
