Dammann O, Allred E N, Veelken N
Department of Neurology, Children's Hospital, Boston, Massachusetts 02115, USA.
J Pediatr. 1998 Mar;132(3 Pt 1):531-5. doi: 10.1016/s0022-3476(98)70035-6.
Our objective was to study the association of spastic diplegia (SDP; N = 29) with the initiator of preterm birth in a regional cohort of 312 6-year-old very low birth weight children (< or =1500 gm). We determined the prevalence of SDP among those children born after idiopathic preterm onset of labor (POOL) or prelabor rupture of membranes (PROM) (12% SDP), and among those born after pregnancy-induced hypertension or other medical indications for preterm delivery (4% SDP). Stratification showed that 83% of the children with diplegia were born after POOL or PROM. The threefold increased risk of SDP among those children born after POOL or PROM compared with the remainder of the cohort (crude odds ratio 3.2, 95% confidence interval 1.2 to 8.5) remained elevated after controlling for perinatal and neonatal variables (odds ratio 2.4 to 2.7) in logistic regression models. We conclude that birth after POOL or PROM increases the risk of SDP among very low birth weight children and speculate that this might be related to infectious processes leading to both POOL or PROM and SDP.
我们的目标是在一个由312名6岁极低出生体重儿童（≤1500克）组成的区域队列中，研究痉挛性双瘫（SDP；N = 29）与早产引发因素之间的关联。我们确定了在特发性早产临产（POOL）或胎膜早破（PROM）后出生的儿童中SDP的患病率（SDP为12%），以及在妊娠高血压或其他早产医学指征后出生的儿童中SDP的患病率（SDP为4%）。分层分析显示，83%的双瘫儿童是在POOL或PROM后出生的。与队列中的其他儿童相比，在POOL或PROM后出生的儿童患SDP的风险增加了三倍（粗比值比3.2，95%置信区间1.2至8.5），在逻辑回归模型中控制围产期和新生儿变量后（比值比2.4至2.7），该风险仍然较高。我们得出结论，POOL或PROM后出生会增加极低出生体重儿童患SDP的风险，并推测这可能与导致POOL或PROM以及SDP的感染过程有关。
