Hypertensive disorders of pregnancy and alterations in brain metabolites in preterm infants: A multi-voxel proton MR spectroscopy study
Hypertensive disorders of pregnancy and alterations in brain metabolites in preterm infants: A multi-voxel proton MR spectroscopy study
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DOI：
10.1016/j.earlhumdev.2021.105479
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发表时间：
2021-10-06
影响因子：
2.5
通讯作者：
Kotani, Tomomi
中科院分区：
文献类型：
--
作者：
Katsuki, Satoru;Ushida, Takafumi;Kotani, Tomomi
背景：妊娠期高血压疾病（HDP）母亲所生的婴儿在以后的生活中有不良的神经发育后果。磁共振波谱（MRS）是用于预测随后的神经发育在围产期领域。目的：我们的目的是确定是否暴露于HDP在子宫内导致改变脑代谢物在早产儿在足月相当的年龄使用多体素质子MRS。研究设计：回顾性队列研究。受试者：2010年至2018年期间在名古屋大学医院出生的妊娠34周前出生的早产儿共计103例。27名婴儿出生于患有HDP的母亲（HDP组），76名婴儿出生于没有HDP的母亲（非HDP组）。结局指标：在10个指定的感兴趣区域（双侧额叶、基底节、丘脑、颞叶和枕叶）评价N-乙酰天冬氨酸（NAA）/胆碱（Cho）、NAA/肌酸（Cr）和Cho/ Cr的峰面积比。结果如下：调整协变量（MRS评估时的月经后年龄和婴儿性别）后，HDP组双侧丘脑NAA/Cho和NAA/Cr的峰面积比显著高于非HDP组。在其他地区未观察到显著差异。先兆子痫、脐动脉血流异常和胎儿生长受限与丘脑中NAA/Cho和NAA/Cr比值升高显著相关。结论：根据正常大脑发育中NAA/Cho和NAA/Cr比率随着月经后年龄的增加而不断增加的证据，宫内暴露于母体HDP可能会加速早产儿的大脑成熟并增加神经元活动。
Background: Infants born to mothers with hypertensive disorders of pregnancy (HDP) have adverse neurodevelopmental consequences in later life. Magnetic resonance spectroscopy (MRS) is used to predict subsequent neurodevelopment in the field of perinatology. Aim: We aimed to determine whether exposure to HDP in utero leads to alterations in brain metabolites in preterm infants using multi-voxel proton MRS at term-equivalent age. Study design: Retrospective cohort study. Subjects: A total of 103 preterm infants born before 34 weeks of gestation at Nagoya University Hospital between 2010 and 2018 were eligible. Twenty-seven infants were born to mothers with HDP (HDP group), and 76 were born to mothers without HDP (non-HDP group). Outcome measures: The peak area ratios of N-acetylaspartate (NAA)/choline (Cho), NAA/creatine (Cr), and Cho/ Cr were evaluated at 10 designated regions of interest (bilateral frontal lobes, basal ganglia, thalami, temporal lobes, and occipital lobes). Results: The peak area ratios of NAA/Cho and NAA/Cr in the bilateral thalami were significantly higher in the HDP group than in the non-HDP group after adjustment for covariates (postmenstrual age at MRS assessment and infant sex). No significant differences were observed in other regions. Preeclampsia, abnormal umbilical artery blood flow, and fetal growth restrictions were significantly associated with increased NAA/Cho and NAA/Cr ratios in the thalami. Conclusions: Based on the evidence that NAA/Cho and NAA/Cr ratios constantly increase with postmenstrual age in normal brain development, exposure to maternal HDP in utero may accelerate brain maturation and increase neuronal activity in preterm infants.