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极低出生体重早产儿伴有轻度脑室内出血对儿童后期的脑容量或神经发育没有影响。

Being born extremely preterm with low-grade intraventricular haemorrhage had no impact on brain volumes or neurodevelopment in later childhood.

作者信息

Broström Lina, de Gamarra-Oca Lexuri Fernández, Kvanta Hedvig, Örtqvist Maria, Padilla Nelly, Ådén Ulrika

机构信息

Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.

Sachs' Children and Youth Hospital, Stockholm, Sweden.

出版信息

Acta Paediatr. 2025 May;114(5):972-979. doi: 10.1111/apa.17517. Epub 2024 Dec 5.

Abstract

AIM

Our aim was to investigate the impact that low-grade intraventricular haemorrhage (IVH) had on neonatal morbidities, brain volumes and neurodevelopmental outcomes in children born extremely preterm (EPT) and compare them with children born EPT without low-grade IVH.

METHODS

This prospective cohort study was carried out in Stockholm, Sweden. It focused on 103 children born EPT from 2004 to 2007, at less than 27 weeks of gestation, without major brain injuries. The group with low-grade IVH, defined as grades I-II, were compared with children born EPT without IVH. Around half (45%) underwent MRI scans at 10 years of age and 55% had neurodevelopmental assessments at 12 years.

RESULTS

The low-grade IVH group was sicker during the neonatal period than the children born EPT without IVH. They had lower gestational ages at birth, more days on mechanical ventilation, a higher incidence of necrotising enterocolitis and were more likely to need surgical ligation of patent ductus arteriosus. However, they did not have significantly smaller brain volumes at 10 years of age or worse neurodevelopmental outcomes at 12 years of age.

CONCLUSION

Brain volumes or neurodevelopment were not affected in children born EPT with low-grade IVH, compared to children born EPT without IVH.

摘要

目的

我们的目的是研究轻度脑室内出血(IVH)对极早产儿(EPT)出生的儿童的新生儿发病率、脑容量和神经发育结局的影响,并将其与未发生轻度IVH的EPT出生儿童进行比较。

方法

这项前瞻性队列研究在瑞典斯德哥尔摩进行。研究重点是2004年至2007年出生的103名EPT儿童,妊娠少于27周,无重大脑损伤。将定义为I-II级的轻度IVH组与未发生IVH的EPT出生儿童进行比较。约一半(45%)的儿童在10岁时接受了MRI扫描,55%的儿童在12岁时进行了神经发育评估。

结果

轻度IVH组在新生儿期比未发生IVH的EPT出生儿童病情更严重。他们出生时的孕周较低,机械通气天数更多,坏死性小肠结肠炎的发生率更高,更有可能需要手术结扎动脉导管未闭。然而,他们在10岁时的脑容量并没有显著减小,在12岁时的神经发育结局也没有更差。

结论

与未发生IVH的EPT出生儿童相比,发生轻度IVH的EPT出生儿童的脑容量或神经发育未受影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a608/11976126/25e5424149ca/APA-114-972-g002.jpg

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