Patterns of brain injury in term neonatal encephalopathy
Patterns of brain injury in term neonatal encephalopathy
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DOI：
10.1016/j.jpeds.2004.12.026
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发表时间：
2005-04-01
影响因子：
5.1
通讯作者：
Ferriero, DM
中科院分区：
文献类型：
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作者：
Miller, SP;Ramaswamy, V;Ferriero, DM
目的探讨足月新生儿脑病的脑损伤类型是否与不同的围产期因素有关，以及损伤类型是否与30个月的神经发育结局有关。研究设计对两个中心173例足月新生儿脑病患者进行磁共振成像(MRI)检查，中位数为6天(1~24天)。结果分水岭损伤78例(45%)，基底节/丘脑损伤44例(25%)，正常新生儿51例(30%)。母体物质使用、妊娠期糖尿病、胎膜早破、先兆子痫和宫内发育受限等产前状况在不同的模式中没有差异。基底节/丘脑模式与更严重的新生儿体征相关，包括更强烈的复苏适合出生(P=.001)，更严重的脑病(P=.0001)和更严重的癫痫(P=.0001)。结论足月新生儿脑病的脑损伤类型与不同的临床表现和神经发育结局有关。测量的产前风险因素不能预测陪审团中的大脑模式。
Objectives To determine whether the pattern of brain injury in term neonatal encephalopathy is associated with distinct prenatal find perinatal factors and to determine whether the pattern of injury is associated with 30-month neurodevelopmental Outcome.Study design A total of 173 term newborns with neonatal encephalopathy from 2 centers underwent magnetic resonance imaging (MRI) at it median of 6 days of age (range, 1-24 days). Patterns of injury on MRI were defined on the basis of the predominant site of injury: watershed predominant, basal ganglia/thalamus predominant, and normal.Results The watershed pattern of in jury was seen in 78 newborns(45%), the basal ganglia/thalamus pattern was seen in 44 newborns (25%), and normal MRI studies were seen in 51 newborns (30%). Antenatal conditions such as maternal substance use, gestational diabetes, premature rupture of membranes, pre-eclampsia, and intra-uterine growth restriction did not differ across patterns. The basal ganglia/thalamus pattern was associated with more severe neonatal signs, including more intensive resuscitation fit birth (P =.001), more severe encephalopathy (P =.0001), and more severe seizures (P =.0001). The basal ganglia/thalamus pattern was associated with the most impaired motor find cognitive outcome fit 30 months.Conclusion The patterns of brain injury in term neonatal encephalopathy are associated with different clinical presentations and neurodevelopmental outcomes. Measured prenatal risk factors did not predict the pattern of brain in jury.