A case-control study of hypoxic-ischemic encephalopathy in newborn infants at >36 weeks gestation
A case-control study of hypoxic-ischemic encephalopathy in newborn infants at >36 weeks gestation
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DOI：
10.1016/j.ajog.2013.03.023
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发表时间：
2013-07-01
影响因子：
9.8
通讯作者：
King, Mary D.
中科院分区：
文献类型：
--
作者：
Hayes, Breda C.;McGarvey, Cliona;King, Mary D.
目的：本研究的目的是确定与缺氧缺血性脑病（HIE）相关的危险因素。研究设计：这是一项病例对照研究，包括2001年1月至2008年12月入院的新生儿HIE。每个病例选择两名对照新生儿。采用Logistic回归和分类回归树（CART）分析方法，对对照组、1级HIE组和对照组、2级和3级HIE组进行比较（新生儿1级脑病155例，新生儿2级脑病61例，3级脑病新生儿21例，对照组489例。与新生儿缺氧缺血性脑病独立相关的变量包括胎粪分级较高、生长受限、头围较大、羊水过少、男性、胎儿心动过缓、母体发热和子宫收缩力增加。CART分析将高胎粪、羊水过少和产科并发症列为最具鉴别力的变量，并定义了不同的危险组，其HIE发生率范围为0-86%.CONCLUSION：CART分析提供了信息，以帮助确定分娩干预可能有益的时间。
OBJECTIVE: The purpose of this study was to determine risk factors that are associated with hypoxic ischemic encephalopathy (HIE).STUDY DESIGN: This was a case-control study that included newborn infants with HIE who were admitted to the hospital between January 2001 and December 2008. Two control newborn infants were chosen for each case. Logistic regression and classification and regression tree (CART) analysis that compared control infants and cases with grade 1 HIE and control infants and cases with grades 2 and 3 HIE was performed.RESULTS: Two hundred thirty-seven cases (newborn infants with grade 1 encephalopathy, 155; newborn infants with grade 2 encephalopathy, 61; newborn infants with grade 3 encephalopathy, 21) and 489 control infants were included. Variables that were associated independently with HIE included higher grade meconium, growth restriction, large head circumference, oligohydramnios, male sex, fetal bradycardia, maternal pyrexia and increased uterine contractility. CART analysis ranked high-grade meconium, oligohydramnios, and the presence of obstetric complications as the most discriminating variables and defined distinct risk groups with HIE rates that ranged from 0-86%.CONCLUSION: CART analysis provides information to help identify the time at which intervention in labor may be of benefit.