Maternal and infant characteristics associated with perinatal arterial stroke in the preterm infant
Maternal and infant characteristics associated with perinatal arterial stroke in the preterm infant
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DOI：
10.1161/strokeaha.106.479311
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发表时间：
2007-06-01
期刊：
影响因子：
8.3
通讯作者：
de Vries, Linda S.
中科院分区：
文献类型：
--
作者：
Benders, Manon J. N. L.;Groenendaal, Floris;de Vries, Linda S.
背景和目的：大多数围产期动脉性卒中（PAS）研究都将早产儿排除在研究人群之外。我们试图分析PAS早产儿的影像学表现和产前及围产期危险因素。方法：这是一项以医院为基础的早产儿病例对照研究。病例婴儿通过检查脑成像扫描和医疗记录（n = 31）得到确认。每个病例的三个对照分别与研究人群中的病例婴儿匹配。结果：胎龄在27 - 36周之间，出生体重在580 - 3180 g之间。PAS更常见于左侧（61%），7%为双侧PAS。大多数中风涉及大脑中动脉分布。1个或多个囊状纹分支受累在胎龄28 ~ 32周的婴儿中最为常见，但主要分支受累仅见于胎龄60 ~ 32周的婴儿。双胎输血综合征、胎儿心率异常和低血糖被确定为PAS的独立危险因素。结论：早产PAS与产前、围产期和产后的危险因素有关。我们无法确定任何母体的风险因素。随着胎龄的增加，大脑中动脉不同分支的受累发生了变化。
Background and Purpose - Most perinatal arterial stroke ( PAS) studies that investigated infant characteristics have excluded preterm infants from the study population. We sought to analyze the imaging findings and antenatal and perinatal risk factors in preterm infants with PAS.Methods - This was a hospital-based, case-control study of preterm infants. Case infants were confirmed by reviewing brain imaging scans and medical records ( n = 31). Three controls per case were individually matched with case infants from the study population.Results - Gestational age ranged between 27 and 36 weeks, and birth weight ranged between 580 and 3180 g. PAS was more common on the left side ( 61%), and 7% had bilateral PAS. The majority of strokes involved the middle cerebral artery distribution. Involvement of 1 or more lenticulostriate branches was most common among infants with a gestational age of 28 to 32 weeks, but main branch involvement was seen only in those with a gestational age of > 32 weeks. Twin-to-twin-transfusion syndrome, fetal heart rate abnormality, and hypoglycemia were identified as independent risk factors for PAS.Conclusions - Preterm PAS is associated with prenatal, perinatal, and postpartum risk factors. We were unable to identify any maternal risk factors. Involvement of the different branches of the middle cerebral artery changed with an increase in gestational age.