Developmental effects on neonatal mortality and subsequent cerebral palsy in infants exposed to intrauterine infection
Developmental effects on neonatal mortality and subsequent cerebral palsy in infants exposed to intrauterine infection
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DOI：
10.1016/j.earlhumdev.2006.09.040
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发表时间：
2007-08-01
影响因子：
2.5
通讯作者：
Ikenoue, Tsuyomu
中科院分区：
文献类型：
--
作者：
Sameshima, Hiroshi;Ikenoue, Tsuyomu
背景：宫内细菌感染是新生儿后续脑损伤的重要高危因素。目的：观察成熟胎儿是否需要缺氧和宫内感染才能导致脑瘫，而白色早产儿是否只需要感染。研究设计：回顾性队列研究。研究对象：1995年至2002年在分娩和分娩过程中暴露于宫内感染的单胎活产婴儿230例，孕22 ~ 32周。方法：比较3组儿童2岁脑瘫死亡率和发病率；未成熟（n=89, 22-27周），早产（n=73, 28-33周）和成熟（n=68， bb0 - 34周）。探讨脑瘫与胎儿pH值的关系。结局指标：死亡率和脑瘫。结果：死亡率和脑卒中发生率。随着妊娠的推进，麻痹明显减少。妊娠28周死亡率显著降低，妊娠34周脑瘫发生率显著降低。在成熟婴儿中酸中毒与脑瘫有关，但在不太成熟的婴儿中没有。结论：早产儿易发生宫内感染致死亡或脑梗死。比成熟婴儿麻痹。成熟婴儿可能需要同时暴露于感染和缺氧环境中，而欠成熟婴儿则需要单独暴露于感染环境中才能导致脑瘫，提示发育阶段的发病机制不同。2006爱思唯尔爱尔兰有限公司版权所有。
Background: Intrauterine bacterial infection is important as a high risk factor associated with subsequent brain damage of the newborn.Aims: To see if mature fetuses require both hypoxia and intrauterine infection to lead to cerebral palsy, white premature fetuses need infection alone.Study design: A retrospective cohort study. Subjects: 230 singleton live-born infants of 22 to 32 weeks of gestation, exposed to intrauterine infection during tabor and delivery, from 1995 to 2002.Methods: Mortality and incidence of cerebral palsy at 2 years old were compared among the 3 groups; immature (n=89, 22-27 weeks), premature (n=73, 28-33 weeks) and mature (n=68, > 34 weeks). The relationship between cerebral palsy and fetal pH values was examined. Outcome measures: Mortality and cerebral palsy.Results: Mortality and cerebral. palsy were significantly decreased with advancing gestation. Mortality was significantly decreased after 28 weeks of gestation while cerebral palsy was significantly decreased after 34 weeks of gestation. Acidosis was associated with cerebral palsy in mature infants, but not in less mature infants.Conclusions: Premature infants were more susceptible to intrauterine infection to cause death or cerebral. palsy than mature infants. Mature infants may require exposures to both infection and hypoxia but less mature infants need infection atone to cause cerebral palsy, suggesting different pathogenesis during the developmental stage. (c) 2006 Elsevier Ireland Ltd. All rights reserved.