Mortality and morbidity of infants with trisomy 21, weighing 1500?grams or less, in Japan
Mortality and morbidity of infants with trisomy 21, weighing 1500?grams or less, in Japan
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日本体重 1500 克或以下的 21 三体婴儿的死亡率和发病率
DOI：
10.1038/s10038-022-01061-w
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发表时间：
2022
影响因子：
3.5
通讯作者：
on behalf of the Neonatal Resea
中科院分区：
文献类型：
--
作者：
Kawasaki Hidenori;Yamada Takahiro;Takahashi Yoshimitsu;Nakayama Takeo;Wada Takahito;Kosugi Shinji;Kusuda Satoshi;Fujimura Masanori;Nakamura Hajime;Nishida Hiroshi;Hirano Shinya;Nakanishi Hidehiko;Sakai Takeo;Kajiwara Masato;on behalf of the Neonatal Resea
虽然极低出生体重（VLBW）在新生儿学中得到了很好的研究，并且随着时间的推移，VLBW婴儿的围产期预后也有所改善，但对于患有21三体（T21）的VLBW婴儿的预后知之甚少。我们的目的是调查日本新生儿重症监护病房（NICU）入院时伴有T21的VLBW婴儿的死亡率和发病率，并与没有出生缺陷（BD−）的婴儿进行比较。前瞻性收集2003 - 2016年日本新生儿研究网络中心收治的体重在1500克及以下的婴儿的母婴数据。在60136名婴儿中，328名（0.55%）患有T21。虽然T21婴儿的产妇年龄较高，但与BD−婴儿相比，产妇并发症的发生率往往较低。多变量分析显示，T21患儿的发病率高于BD患儿，但T21患儿呼吸窘迫综合征和早产儿视网膜病变发生率较低（p< 0.001, p= 0.014），两组间迟发性早产儿循环衰竭和囊性脑室周围白质软化的比例无显著差异（p= 0.739, p= 0.733）。T21和BD -患儿出院时存活率分别为77%和94%。这是日本首次对患有T21的VLBW婴儿进行全国性调查。虽然没有关于诊断时间的数据，但这些数据将有助于T21婴儿的产前遗传咨询和围产期管理。
Although very low birth weight (VLBW) is well studied in neonatology and the perinatal prognosis of VLBW infants has improved over time, little is known about the prognosis of VLBW infants with trisomy 21 (T21). We aimed to investigate the mortality and morbidity of VLBW infants with T21 during NICU admission in Japan, in comparison to those of infants without birth defects (BD−). Maternal and neonatal data of infants weighing 1500 grams or less admitted to the centers of the Neonatal Research Network of Japan from 2003 to 2016 were collected prospectively. Of 60,136 infants, 328 (0.55%) had T21. Although maternal age in the case of T21 infants was higher, maternal complications tended to be less frequent than in those with BD−. Multivariable analysis revealed that morbidities were higher in infants with T21 than in those with BD− but respiratory distress syndrome and retinopathy of prematurity were less frequent in those with T21 (p< 0.001, andp= 0.014, respectively), and no significant difference was observed between the two groups in the proportion of late-onset circulatory collapse of prematurity as well as cystic periventricular leukomalacia (p= 0.739 andp= 0.733, respectively). The survival rate at discharge from the NICU was 77% and 94% for T21 and BD−, respectively. This was the first nationwide survey of VLBW infants with T21 in Japan. Although there were no data regarding the timing of diagnosis, these data will aid prenatal genetic counseling and perinatal management of T21 infants.