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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Intraventricular hemorrhage and neurodevelopmental outcomes in extreme preterm infants
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Intraventricular hemorrhage and neurodevelopmental outcomes in extreme preterm infants

机译：极端早产儿的脑室内出血和神经​​发育结局

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OBJECTIVE: Not many large studies have reported the true impact of lower-grade intraventricular hemorrhages in preterm infants. We studied the neurodevelopmental outcomes of extremely preterm infants in relation to the severity of intraventricular hemorrhage. METHODS: A regional cohort study of infants born at 23 to 28 weeks' gestation and admitted to a NICU between 1998 and 2004. Primary outcome measure was moderate to severe neurosensory impairment at 2 to 3 years' corrected age defined as developmental delay (developmental quotient >2 SD below the mean), cerebral palsy, bilateral deafness, or bilateral blindness. RESULTS: Of the 1472 survivors assessed, infants with grade III-IV intraventricular hemorrhage (IVH; n = 93) had higher rates of developmental delay (17.5%), cerebral palsy (30%), deafness (8.6%), and blindness (2.2%). Grade I-II IVH infants (n = 336) also had increased rates of neurosensory impairment (22% vs 12.1%), developmental delay (7.8% vs 3.4%), cerebral palsy (10.4% vs 6.5%), and deafness (6.0% vs 2.3%) compared with the no IVH group (n = 1043). After exclusion of 40 infants with late ultrasound findings (periventricular leukomalacia, porencephaly, ventricular enlargement), isolated grade I-II IVH (n = 296) had increased rates of moderate-severe neurosensory impairment (18.6% vs 12.1%). Isolated grade I-II IVH was also independently associated with a higher risk of neurosensory impairment (adjusted odds ratio 1.73, 95% confidence interval 1.22-2.46). CONCLUSIONS: Grade I-II IVH, even with no documented white matter injury or other late ultrasound abnormalities, is associated with adverse neurodevelopmental outcomes in extremely preterm infants.
机译：目的：很少有大型研究报道低度脑室内出血对早产儿的真正影响。我们研究了与脑室内出血的严重程度有关的极早产儿的神经发育结局。方法：一项区域队列研究，研究对象为1998年至2004年间在妊娠23至28周出生并接受新生儿重症监护病房（NICU）的婴儿。主要结局指标为校正后的2至3岁年龄为中度至重度神经感觉障碍，即发育迟缓（发育商低于均值> 2 SD），脑瘫，双侧耳聋或双眼失明。结果：在评估的1472名幸存者中，III-IV级脑室内出血（IVH; n = 93）的婴儿发育延迟（17.5％），脑瘫（30％），耳聋（8.6％）和失明（ 2.2％）。 I-II级IVH婴儿（n = 336）的神经感觉障碍发生率（22％比12.1％），发育迟缓（7.8％比3.4％），脑瘫（10.4％比6.5％）和耳聋（6.0％）增加％vs. 2.3％）与无IVH组相比（n = 1043）。在排除40例超声检查较晚的婴儿（室周白细胞减少，脑孔扩大，心室扩大）后，孤立的I-II级IVH（n = 296）增加了中度-重度神经感觉障碍的发生率（18.6％比12.1％）。孤立的I-II级IVH也与神经感觉障碍的较高风险相关（校正比值比1.73，95％置信区间1.22-2.46）。结论：I-II IVH级，即使没有记录的白质损伤或其他晚期超声异常，也与极早产儿不良的神经发育结果相关。

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