Severity of perinatal illness and cerebral cortical growth in preterm infants
Severity of perinatal illness and cerebral cortical growth in preterm infants
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DOI：
10.1111/j.1651-2227.2009.01268.x
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发表时间：
2009-06-01
期刊：
影响因子：
3.8
通讯作者：
Edwards, A. David
中科院分区：
文献类型：
--
作者：
Kaukola, Tuula;Kapellou, Olga;Edwards, A. David
目的：我们以前已经表明，早产的程度影响皮质表面积的增长。我们现在讨论的问题是否皮质表面积的增长早产后预测的严重程度，产前和产后illness.Methods：皮质表面积测量269图像从111个婴儿出生23至29周，成像在23至48周胎龄（GA）。使用婴儿临床风险指数评分（CRIB I）评估围产期疾病的严重程度，并通过慢性肺部疾病（CLD）的存在评估持续疾病的严重程度。使用Bonferroni校正的随机效应广义最小二乘回归对皮质生长的影响进行建模。为了进一步探索结果，我们检查CRIB II，C-反应蛋白（CRP）在出生后第二天，以及所需的时间，以实现充分的肠内feeding.Results：皮质表面积增长了12.4%，每周。通过不利的CRIB I（每周每单位-0.15%）和CLD的发展（每周-1.18%）预测皮质生长减少。二次分析表明，生长与不利CRIB II（-0.36%每周每单位）和增加CRP（-0.03%每周每mMol），但不是通过所需的时间，以实现充分的肠内feeding.Conclusion：非常早产后，疾病的严重程度预测皮质生长减少。
Aim: We have shown previously that the degree of prematurity affects cortical surface area growth. We now addressed the question whether cortical surface area growth after preterm birth is predicted by the severity of peri- and postnatal illness.Methods: Cortical surface area was measured in 269 images from 111 infants born between 23 and 29 weeks and imaged at 23 to 48 weeks gestational age (GA). The severity of perinatal illness was assessed using the clinical risk index for babies score (CRIB I) and the severity of ongoing illness by the presence of chronic lung disease (CLD). The effects on cortical growth were modelled using generalized least-square regression for random effects with Bonferroni correction. To explore the results further we examined CRIB II, C-reactive protein (CRP) on the second day after birth, and time taken to achieve full enteral feeding.Results: Cortical surface area grew by 12.4% per week. Reduced cortical growth was predicted by adverse CRIB I (-0.15% per week per unit) and development of CLD (-1.18% per week). Secondary analysis showed that growth was related to adverse CRIB II (-0.36% per week per unit) and increasing CRP (-0.03% per week per mMol), but not by the time taken to achieve full enteral feeding.Conclusion: After very premature birth illness severity predicts reduced cortical growth.