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维多利亚州孕24 - 26周出生儿童至5岁的结局。维多利亚州婴儿协作研究小组。

Outcome to five years of age of children born at 24-26 weeks' gestational age in Victoria. The Victorian Infant Collaborative Study Group.

作者信息

Doyle L W

机构信息

Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Vic.

出版信息

Med J Aust. 1995 Jul 3;163(1):11-4.

PMID:7541889
Abstract

OBJECTIVE

To determine the outcome to five years of age of liveborn children born at 24-26 weeks' gestation.

DESIGN

Regional cohort study of preterm children.

SUBJECTS

Consecutive children liveborn at 24-26 weeks' gestation in Victoria from 1 January 1985 to 31 December 1987.

MAIN OUTCOME MEASURES

Survival rates and rates of sensorineural impairment and disability at five years of age.

RESULTS

95 of 316 (30.1%) children survived to five years; survival rates increased with gestational age. 94 children (99%) were assessed at five or more years of age, corrected for prematurity. Twelve children had some form of cerebral palsy, causing a severe disability in only one. Two children required hearing aids for sensorineural deafness, five had bilateral blindness, and four were too disabled for intelligence quotient measurement. Overall, sensorineural disability was severe in seven (7.4%), moderate in seven (7.4%), mild in 23 (24.5%), and nil in 57 (60.6%) of children assessed. There was no trend to increasing disability with lower gestational age.

CONCLUSIONS

The sensorineural outcome for this cohort is mostly favourable, and is better than that reported from some contemporaneous regional cohorts born in other parts of the world. The rates of sensorineural impairments, such as blindness and cerebral palsy, are higher than in non-preterm children but are not inordinately high, and most have no sensorineural impairment or disability.

摘要

目的

确定孕24 - 26周出生的活产儿至5岁时的结局。

设计

对早产儿童的区域性队列研究。

研究对象

1985年1月1日至1987年12月31日在维多利亚州孕24 - 26周出生的连续活产儿。

主要观察指标

5岁时的生存率、感觉神经性损伤和残疾发生率。

结果

316名儿童中有95名(30.1%)存活至5岁;生存率随孕周增加而升高。94名儿童(99%)在5岁及以上接受了评估,已校正早产因素。12名儿童患有某种形式的脑瘫,仅1名导致严重残疾。2名儿童因感觉神经性耳聋需要佩戴助听器,5名儿童双目失明,4名儿童因残疾程度过重无法进行智商测量。总体而言,在接受评估的儿童中,7名(7.4%)感觉神经性残疾严重,7名(7.4%)为中度,23名(24.5%)为轻度,57名(60.6%)无残疾。未发现随着孕周降低残疾程度增加的趋势。

结论

该队列的感觉神经结局大多良好,优于世界其他地区同期出生的一些区域性队列所报告的结局。感觉神经性损伤(如失明和脑瘫)的发生率高于非早产儿童,但并非过高,且大多数儿童无感觉神经性损伤或残疾。

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