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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Neurodevelopmental outcomes of extremely low birth weight infants <32 weeks' gestation between 1993 and 1998.
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Neurodevelopmental outcomes of extremely low birth weight infants <32 weeks' gestation between 1993 and 1998.

机译：1993年至1998年之间小于32周妊娠的极低出生体重婴儿的神经发育结果。

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OBJECTIVE: This study evaluated the impact of changes in perinatal management on neurodevelopmental impairment (NDI) at 18 to 22 months' corrected age of low gestation (22-26 weeks) and higher gestation (27-32 weeks) extremely low birth weight infants (401-1000 g birth weight) who were cared for in the National Institute of Child Health and Human Development Neonatal Research Network during 3 epochs (1993-1994, 1995-1996, and 1997-1998). It was hypothesized that outcomes would improve over the 3 epochs. METHODS: A multicenter cohort study was conducted of the outcomes of 3785 infants with assessments at 18 to 22 months' corrected age. Regression analyses were completed to evaluate for epoch effects, gestational age effects, and time plus gestational age interaction. Regression analyses were also performed to identify the independent associations of epoch and 4 study perinatal interventions: antenatal steroids (yes, no), high-frequency ventilation (yes, no), number of days to regain birth weight as a marker of nutritional intake, and postnatal steroids for treatment of bronchopulmonary dysplasia (yes, no) with outcomes. RESULTS: Survival improved for both the low (55%-61%) and higher (82%-86%) gestational age groups during the 3 epochs. Regression analyses indicated that the decreased risk for adverse outcome was significantly lower in epoch 2 compared with epoch 1 with decreased rates of low Bayley Mental Development Index (MDI) and neurodevelopmental impairment (NDI). Antenatal steroids were associated with decreased risk for moderate to severe cerebral palsy (CP) and low Bayley Psychomotor Development Index. High-frequency ventilation was associated with a low Bayley MDI and NDI, and postnatal steroids were associated with moderate to severe CP, any CP, low Bayley MDI, low Bayley Psychomotor Development Index, and increased NDI. CONCLUSION: Survival of extremely low birth weight infants improved between 1993 and 1998. Although some outcomes remained unchanged, the rates of low Bayley MDI scores and NDIimproved. Antenatal steroid administration was the only study intervention associated with improved outcomes.
机译：目的：本研究评估了围产期管理变化对极低出生体重婴儿（低孕期（22-26周）和高孕期（27-32周）的矫正年龄在18至22个月时神经发育障碍（NDI）的影响（在3个时期（1993年至1994年，1995年至1996年和1997年至1998年）在美国国家儿童健康与人类发展研究所新生儿研究网络中得到照顾的新生儿（体重401-1000 g）。假设结果将在三个时期内有所改善。方法：进行了一项多中心队列研究，对3785例婴儿的结局进行了评估，校正了18至22个月的年龄。完成回归分析以评估时代效应，胎龄效应以及时间与胎龄的相互作用。还进行了回归分析，以确定时期与4种研究围产期干预措施的独立关联：产前类固醇（是，否），高频通气（是，否），恢复出生体重的天数作为营养摄入的标志，和出生后的类固醇激素治疗支气管肺发育不良（是，否）并具有预后。结果：在三个时期中，低胎龄组（55％-61％）和高胎龄组（82％-86％）的存活率均有改善。回归分析表明，与第1阶段相比，第2阶段的不良结局降低风险显着降低，而Bayley心理发展指数（MDI）和神经发育障碍（NDI）降低。产前类固醇与中度至重度脑瘫（CP）风险降低和Bayley精神运动发育指数低有关。高频通气与Bayley MDI和NDI降低有关，而出生后的类固醇与中度至重度CP，任何CP，Bayley MDI低，Bayley精神运动发育指数低和NDI增加有关。结论：1993年至1998年间，极低出生体重婴儿的存活率有所提高。尽管某些结局保持不变，但Bayley MDI评分低和NDI的发生率有所提高。产前激素治疗是唯一与改善结局相关的研究干预措施。

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