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对生长迟缓新生儿的18个月随访研究。与妊娠晚期胎盘功能的生化检测及新生儿期神经行为状况的关系。

An 18-month follow-up study of growth-retarded neonates. Relation to biochemical tests of placental function in late pregnancy and neurobehavioural condition in the newborn period.

作者信息

Leijon I, Billström G, Lind I

出版信息

Early Hum Dev. 1980 Sep;4(3):271-85. doi: 10.1016/0378-3782(80)90031-6.

DOI:10.1016/0378-3782(80)90031-6
PMID:6158397
Abstract

Serial estimations of maternal urinary oestriol, serum cystine aminopeptidase (S-CAP), and human chorionic somatomammotrophin (S-HCS) were studied prospectively in 29 pregnancies complicated by intrauterine growth retardation. The newborn growth-retarded infants were examined by neurological and behavioural techniques. Growth variables and neurological and developmental findings were compared with those in 18 healthy controls at 5, 10 and 18 months of age. The growth-retarded infants caught up with regard to body size from 5 months of age, although the severely retarded infants (birth weight less than or equal to -2 SD) differed from the controls with regard to weight and head circumference at 18 months of age. Abnormal maternal oestriol excretions were negatively correlated to weight and length during the follow-up period. Infants who had been severely growth-retarded at birth were neurologically below optimal level at 10 months of age, compared to the controls. There were no significant differences between the growth-retarded infants and the controls with regard to psychomotor development, as assessed by a screening test and by Griffiths' method. Significant correlations were found between abnormal biochemical placental tests (especially urinary oestriol and S-CAP) and psychomotor development. Significant correlations also appeared between neonatal orientation and motor behaviour and some Griffiths' scales at 18 months of age. No relationship was found between the neurological condition in the neonatal period and the neurological findings and development at follow-up.

摘要

对29例合并宫内生长迟缓的妊娠进行了前瞻性研究,连续测定孕妇尿雌三醇、血清胱氨酸氨基肽酶(S-CAP)和人绒毛膜生长催乳素(S-HCS)。对出生时生长迟缓的新生儿采用神经学和行为学技术进行检查。将生长变量以及神经学和发育结果与18名健康对照者在5个月、10个月和18个月时的情况进行比较。生长迟缓的婴儿从5个月大时开始在体型方面追赶上来,不过严重迟缓的婴儿(出生体重小于或等于-2标准差)在18个月大时在体重和头围方面与对照组存在差异。在随访期间,孕妇雌三醇排泄异常与体重和身长呈负相关。与对照组相比,出生时严重生长迟缓的婴儿在10个月大时神经学水平低于最佳水平。通过筛查测试和格里菲斯方法评估,生长迟缓的婴儿与对照组在精神运动发育方面没有显著差异。在异常的胎盘生化检测(尤其是尿雌三醇和S-CAP)与精神运动发育之间发现了显著相关性。在18个月大时,新生儿的定向和运动行为与一些格里菲斯量表之间也出现了显著相关性。未发现新生儿期的神经状况与随访时的神经学结果及发育之间存在关联。

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