Adverse neurodevelopment in preterm infants with postnatal sepsis or necrotizing enterocolitis is mediated by white matter abnormalities on magnetic resonance imaging at term
Adverse neurodevelopment in preterm infants with postnatal sepsis or necrotizing enterocolitis is mediated by white matter abnormalities on magnetic resonance imaging at term
复制标题
DOI：
10.1016/j.jpeds.2008.02.033
复制
发表时间：
2008-08-01
影响因子：
5.1
通讯作者：
Inder, Terrif E.
中科院分区：
文献类型：
--
作者：
Shah, Divyen K.;Doyle, Lex W.;Inder, Terrif E.
目的探讨白色物质异常（WMA）对新生儿败血症/坏死性小肠结肠炎（NEC）神经发育的影响。研究设计：192例早产儿的前瞻性队列研究（胎龄< 30周），评估败血症和NEC，在足月时进行影像学检查，并在2岁时使用Bayley婴儿发育量表进行神经发育结果分析。婴儿有100次确诊的败血症发作，9例（5%）婴儿确诊NEC。凝固酶阴性葡萄球菌占73%（73/100）的确诊败血症发作。与非败血症/N-EC组相比，败血症/NEC组婴儿在足月时的MRI上具有显著更多的WMA。他们也有较差的精神发育，持续调整后，潜在的混杂因素，但调整后WMA.Conclusions早产儿败血症/NEC的运动障碍的风险更大，在2年，这似乎是介导的WMA。这些发现可能有助于确定早产儿败血症/NEC的神经保护目标。
Objectives To test the hypothesis that the impact of postnatal sepsis/necrotizing enterocolitis (NEC) on neurodevelopment may be mediated by white matter abnormality (WMA). which call be demonstrated with magnetic resonance imaging (MRI).Study design A prospective cohort of 192 unselected preterm infants (gestational age < 30 weeks), who were evaluated for sepsis and NEC, underwent imaging at term-equivalent age and neurodevelopmental outcome at 2 years corrected age with the Bayley Scales of Infant Development.Results Sixty-eight preterm (35%) infants had 100 episodes of confirmed sepsis, and 9 (5%) infants had confirmed NEC. Coagulase-negative staphylococci accounted for 73% (73/100) of the episodes of confirmed sepsis. Infants with sepsis/NEC had significantly more WMA on MRI at term compared with infants in the no-sepsis/N-EC group. They also had poorer psychomotor development that persisted after adjusting for potential confounders but which became nonsignificant after adjusting for WMA.Conclusions Preterm infants with sepsis/NEC are at greater risk of motor impairment at 2 years, which appears to be mediated by WMA. These findings may assist in defining a neuroprotective target in preterm infants with sepsis/NEC.