Scherjon S A, Oosting H, de Visser B W, de Wilde T, Zondervan H A, Kok J H
Graduate School Neurosciences Amsterdam, Department of Obstetrics and Gynaecology, The Netherlands.
Am J Obstet Gynecol. 1996 Dec;175(6):1569-75. doi: 10.1016/s0002-9378(96)70108-4.
Our purpose was to assess the effects that fetal growth restriction exerts on the myelination of the developing brain.
Fetal haemodynamic centralization, an adaptive strategy to growth restriction caused by placental insufficiency, was determined by Doppler ultrasonography. Infants with a raised ratio between umbilical artery pulsatility index and cerebral artery pulsatility index are severely growth restricted. Visual evoked potentials give information on the degree of brain myelination. Shortening of visual evoked potential latencies is a normal feature of myelination. In a consecutive series of 105 Neonates, visual evoked potentials were recorded at the corrected ages of 6 months and 1 years. Correction for possible confounders, such as cranial ultrasonographic findings, gestational age, and head circumference, was performed.
At 6 months, infants with a raised umbilical artery/cerebral artery pulsatility index ratio have shorter visual evoked potential latencies. Opposite of neonates with a normal umbilical artery/cerebral artery ratio, they show no postnatal maturational shortening of visual evoked potential latencies.
Accelerated neurophysiologic maturation, found in infants with a high umbilical artery/cerebral artery ratio, might be the result of a beneficial adaptive process to severe fetal growth restriction.
我们的目的是评估胎儿生长受限对发育中大脑髓鞘形成的影响。
通过多普勒超声检查确定胎儿血流动力学集中化，这是对胎盘功能不全导致的生长受限的一种适应性策略。脐动脉搏动指数与脑动脉搏动指数之比升高的婴儿存在严重生长受限。视觉诱发电位可提供有关大脑髓鞘形成程度的信息。视觉诱发电位潜伏期缩短是髓鞘形成的正常特征。在连续的105例新生儿系列中，在矫正年龄6个月和1岁时记录视觉诱发电位。对可能的混杂因素进行校正，如头颅超声检查结果、胎龄和头围。
在6个月时，脐动脉/脑动脉搏动指数比升高的婴儿视觉诱发电位潜伏期较短。与脐动脉/脑动脉比值正常的新生儿相反，他们的视觉诱发电位潜伏期在出生后没有成熟性缩短。
脐动脉/脑动脉比值高的婴儿中发现的神经生理成熟加速，可能是对严重胎儿生长受限的一种有益适应性过程的结果。
