22至25周出生且接受积极护理的婴儿的神经学结局及相关围产期因素
Neurological outcomes and associated perinatal factors in infants born between 22 and 25 weeks with active care.
作者信息
Ariyoshi Yu, Iriyama Takayuki, Seyama Takahiro, Sayama Seisuke, Yano Eriko, Suzuki Kensuke, Samejima Taiki, Ichinose Mari, Toshimitsu Masatake, Sone Kenbun, Ito Atsushi, Shitara Yoshihiko, Kumasawa Keiichi, Kashima Kohei, Kakiuchi Satsuki, Hirota Yasushi, Takahashi Naoto, Osuga Yutaka
机构信息
Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Pediatrics, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
出版信息
J Perinatol. 2025 Feb;45(2):186-193. doi: 10.1038/s41372-024-02093-0. Epub 2024 Sep 18.
OBJECTIVES
To elucidate the outcomes of periviable infants receiving active care (AC) and explore perinatal factors associated with neurodevelopmental outcomes.
METHODS
This is a single-center retrospective study on infants born at 22-25 weeks of gestation, all of whom received AC. A developmental quotient (DQ) ≥ 85 at corrected 18 months was judged as normal.
RESULTS
Fifty-seven infants were included in the study. The survival rates at discharge were 83%, 86%, 93%, and 93% at 22, 23, 24, and 25 gestational weeks, respectively. The overall percentage of normal DQ was 26/47 (55%). Acidemia in the arterial blood gas measured within 6 h after birth was identified as a factor significantly associated with subnormal DQ.
CONCLUSIONS
Not only high survival rates, but also favorable neurodevelopmental outcomes may be achieved by AC in periviable infants. Moreover, impaired neurodevelopmental outcomes may be associated with early postnatal acidemia following initial resuscitation.
目的
阐明接受积极治疗（AC）的可存活婴儿的结局，并探讨与神经发育结局相关的围产期因素。
方法
这是一项针对妊娠22至25周出生的婴儿的单中心回顾性研究，所有婴儿均接受了AC治疗。校正18个月时发育商（DQ）≥85被判定为正常。
结果
57名婴儿纳入研究。在22、23、24和25孕周时，出院存活率分别为83%、86%、93%和93%。DQ正常的总体比例为26/47（55%）。出生后6小时内测得的动脉血气酸血症被确定为与DQ低于正常水平显著相关的因素。
结论
AC不仅可以使可存活婴儿获得高存活率，还能带来良好的神经发育结局。此外，神经发育结局受损可能与初始复苏后早期产后酸血症有关。
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