Increased Risk of Adverse Neurological Development for Late Preterm Infants
Increased Risk of Adverse Neurological Development for Late Preterm Infants
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DOI：
10.1016/j.jpeds.2008.08.020
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发表时间：
2009-02-01
影响因子：
5.1
通讯作者：
Escobar, Gabriel J.
中科院分区：
文献类型：
--
作者：
Petrini, Joann R.;Dias, Todd;Escobar, Gabriel J.
目的评估中度早产儿脑性瘫痪（CP）、发育迟缓/智力低下（DD/MR）和早期儿童癫痫发作的风险。研究设计：回顾性队列研究，使用来自北方加州Kaiser Permanente医疗保健项目的住院和门诊数据库。数据涵盖了141321名出生于2000年1月1日至2004年6月30日之间的>= 30周的儿童，随访至2005年6月30日。CP、DD/MR和癫痫发作的存在基于国际分类。疾病，第九次修订的代码中确定的遭遇数据。单独的考克斯比例风险模型用于每个结果，粗和调整后的风险比计算每个胎龄group.Results胎龄下降与CP和DD/MR的发病率增加，即使是那些出生在34至36周的妊娠。晚期早产儿被诊断为CP的可能性是足月儿的3倍（风险比，3.39：95%CI，2.54-4.52）。发现34至36周出生的儿童与DD/MR存在中度相关性（风险比，1.25; 95%CI）。结论早产与长期的神经发育后果有关，随着妊娠期的减少，风险增加，即使是在34至36周出生的婴儿。（J Pediatr 2009;154;369-76）
Objective To assess the risks of moderate prematurity for cerebral palsy (CP), developmental delay/mental retardation (DD/MR), and seizure disorders in early childhood.Study design Retrospective cohort study using hospitalization and outpatient databases from the Northern California Kaiser Permanente Medical Care Program. Data covered 141321 children >= 30 weeks born between Jan 1, 2000, and June 30, 2004, with follow-up through Jun 30, 2005. Presence of CP, DD/MR, and seizures was based on International Classification. of Diseases, Ninth Revision codes identified in the encounter data. Separate Cox proportional hazard models were used for each of the outcomes, with crude and adjusted hazard ratios calculated for each gestational age group.Results Decreasing gestational age was associated with increased incidence of CP and DD/MR, even for those born at 34 to 36 weeks gestation. Children born late preterm were >3 times as likely (hazard ratio, 3.39: 95% CI, 2.54-4.52) is children born at term to he diagnosed with CP. A modest association with DD/MR was found for children born at 34 to 36 weeks (hazard ratio, 1.25; 95% CI. 1.01-1.54), but not for children in whom seizures were diagnosed.Conclusions Prematurity is associated with long-term neurodevelopmental consequences, with risks increasing as gestation decreases, even in infants born at 34 to 36 weeks. (J Pediatr 2009;154;369-76)