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产科管理对极早早产生长受限婴儿结局的影响。

Influence of obstetric management on outcome of extremely preterm growth retarded infants.

作者信息

Schaap A H, Wolf H, Bruinse H W, den Ouden A L, Smolders-de Haas H, van Ertbruggen I, Treffers P E

机构信息

Department of Obstetrics, University of Amsterdam, The Netherlands.

出版信息

Arch Dis Child Fetal Neonatal Ed. 1997 Sep;77(2):F95-9. doi: 10.1136/fn.77.2.f95.

Abstract

AIM

To describe the long term outcome of extremely preterm growth retarded infants in relation to obstetric management and various perinatal events.

METHODS

A cohort study was undertaken in two tertiary care centres with different obstetric management. All infants with fetal growth retardation due to placental insufficiency and resulting in fetal distress at 26 to 32 weeks of gestation, were included for the years 1984-89. Main outcome measures were impairment, disability, or handicap at 2 years corrected age and at school age (4 1/2 to 10 1/2 years).

RESULTS

One hundred and twenty five (98%) were followed up until 2 years corrected age in the outpatient department; 114 (90%) were assessed at school age. Impairments were found in 37% and disabilities or handicaps in 9% of the assessed infants, with no difference between centres. All disabled or handicapped children had already been identified by 2 years corrected age.

CONCLUSIONS

Disability or handicap were related to neonatal complications (intracerebral haemorrhage or bronchopulmonary dysplasia) and not to obstetric variables, thus making antenatal prediction impossible. The incidence of disability or handicap in these growth retarded infants was comparable with that of other preterm infants.

摘要

目的

描述极早产生长受限婴儿与产科管理及各种围产期事件相关的长期结局。

方法

在两个采用不同产科管理的三级护理中心进行了一项队列研究。纳入1984 - 1989年间所有因胎盘功能不全导致胎儿生长受限且在妊娠26至32周时出现胎儿窘迫的婴儿。主要结局指标为矫正年龄2岁时和学龄期(4.5至10.5岁)的损伤、残疾或障碍情况。

结果

125例(98%)婴儿在门诊随访至矫正年龄2岁;114例(90%)在学龄期接受评估。在接受评估的婴儿中,37%存在损伤,9%存在残疾或障碍,两个中心之间无差异。所有残疾或有障碍的儿童在矫正年龄2岁时已被识别。

结论

残疾或障碍与新生儿并发症(脑内出血或支气管肺发育不良)相关,而与产科变量无关,因此产前预测是不可能的。这些生长受限婴儿的残疾或障碍发生率与其他早产儿相当。

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