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首页> 外文期刊>Pediatric neurology >Score for neonatal acute physiology-II and neonatal pain predict Corticospinal tract development in premature newborns
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Score for neonatal acute physiology-II and neonatal pain predict Corticospinal tract development in premature newborns

机译：新生儿急性生理学II分和新生儿疼痛可预测早产儿的皮质脊髓束发育

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摘要

Premature infants are at risk for adverse motor outcomes, including cerebral palsy and developmental coordination disorder. The purpose of this study was to examine the relationship of antenatal, perinatal, and postnatal risk factors for abnormal development of the corticospinal tract, the major voluntary motor pathway, during the neonatal period. In a prospective cohort study, 126 premature neonates (24-32 weeks' gestational age) underwent serial brain imaging near birth and at term-equivalent age. With diffusion tensor tractography, mean diffusivity and fractional anisotropy of the corticospinal tract were measured to reflect microstructural development. Generalized estimating equation models examined associations of risk factors on corticospinal tract development. The perinatal risk factor of greater early illness severity (as measured by the Score for Neonatal Acute Physiology-II [SNAP-II]) was associated with a slower rise in fractional anisotropy of the corticospinal tract (P = 0.02), even after correcting for gestational age at birth and postnatal risk factors (P = 0.009). Consistent with previous findings, neonatal pain adjusted for morphine and postnatal infection were also associated with a slower rise in fractional anisotropy of the corticospinal tract (P = 0.03 and 0.02, respectively). Lessening illness severity in the first hours of life might offer potential to improve motor pathway development in premature newborns.
机译：早产儿有发生不良运动结果的风险，包括脑瘫和发育协调障碍。这项研究的目的是检查新生儿时期皮质脊髓束异常发育（主要的自主运动途径）的产前，围产期和产后危险因素之间的关系。在一项前瞻性队列研究中，对126名早产新生儿（胎龄24-32周）在出生前后和足月等效年龄进行了连续脑成像。用弥散张量束摄影术，测量皮质脊髓束的平均弥散率和分数各向异性，以反映微观结构的发展。广义估计方程模型检查了皮质脊髓束发育的危险因素的关联。即使校正校正后，围产期早期疾病严重程度较高的危险因素（通过新生儿急性生理学-II评分[SNAP-II]衡量）也与皮质脊髓束分数各向异性的升高较慢有关（P = 0.02）。出生时的胎龄和产后危险因素（P = 0.009）。与先前的发现一致，调整吗啡和产后感染的新生儿疼痛也与皮质脊髓束分数各向异性的升高较慢有关（分别为P = 0.03和0.02）。在出生后的头几个小时内减轻疾病的严重程度可能为改善早产儿的运动途径发展提供潜力。

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