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首页> 外文期刊>British Journal of Haematology >Neonatal bleeding in haemophilia: A European cohort study
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Neonatal bleeding in haemophilia: A European cohort study

机译：血友病新生儿出血：一项欧洲队列研究

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摘要

Birth is the first haemostatic challenge for a child with haemophilia. Our aim was to examine the association between perinatal risk factors and major neonatal bleeding in infants with haemophilia. This observational cohort study in 12 European haemophilia treatment centres (HTC) incorporated 508 children with haemophilia A or B, born between 1990 and 2008. Risk factors for bleeding were analysed by univariate analysis. Head bleeds occurred in 18 (3·5%) children within the first 28d of life, including three intraparenchymal bleeds, one subdural haematoma and 14 cephalohaematomas. Intra-cranial bleeds were associated with long-term neurological sequelae in two (0·4%) cases; no deaths occurred. Assisted delivery (forceps/vacuum) was the only risk factor for neonatal head bleeding [Odds Ratio (OR) 8·84: 95% confidence interval (CI) 3·05-25·61]. Mild haemophilia and maternal awareness of her haemophilia carrier status seemed to be protective (OR 0·24; 95%CI 0·05-1·05 and OR 0·34; 95%CI 0·10-1·21, respectively), but due to the low number of events this was not statistically significant. We found no association between neonatal head bleeding and country, maternal age, parity, gestational age or presence of HTC. Maternal awareness of carrier status protected against assisted delivery (unadjusted OR 0·37; 95%CI 0·15-0·90; adjusted OR 0·47 (95%CI 0·18-1·21).
机译：出生是患有血友病儿童的第一个止血挑战。我们的目的是检查血友病婴儿围生期危险因素与新生儿重大出血之间的关系。这项在12个欧洲血友病治疗中心（HTC）进行的观察性队列研究纳入了508例出生于1990年至2008年之间的508例A型或B型血友病儿童。在出生后的28天内，有18名（3·5％）儿童发生头部出血，包括3例实质内出血，1例硬膜下血肿和14例头颅血肿。颅内出血与长期神经系统后遗症相关（2例（0·4％））;没有死亡发生。辅助分娩（镊子/真空）是新生儿头部出血的唯一危险因素[几率（OR）8·84：95％置信区间（CI）3·05-25·61]。轻度血友病和母亲对其血友病携带者状态的了解似乎是保护性的（OR 0·24; 95％CI 0·05-1·05和OR 0·34; 95％CI 0·10-1·21），但是由于事件数量少，因此在统计上并不显着。我们发现新生儿头部出血与国家/地区，产妇年龄，胎龄，胎龄或HTC是否存在关联。孕产妇对携带者状况的意识可以防止分娩（未调整OR 0·37; 95％CI 0·15-0·90;调整OR 0·47（95％CI 0·18-1·21）。

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