Extrauterine Neuromaturation of Low Risk Preterm Infants
Extrauterine Neuromaturation of Low Risk Preterm Infants
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DOI：
10.1203/pdr.0b013e3181998b86
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发表时间：
2009-05-01
影响因子：
3.6
通讯作者：
Donohue, Pamela K.
中科院分区：
文献类型：
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作者：
Allen, Marilee C.;Aucott, Susan;Donohue, Pamela K.
这项研究的目的是跟踪早产儿的神经成熟。从90个低风险极低出生体重儿的系列检查中，每个婴儿的成熟度评分（音调，反射和反应项目的总和）与检查时的月经后年龄（PMA）作图。每个婴儿的估计最佳拟合线提供了该婴儿神经成熟的两个描述符：斜率（个体成熟度斜率）和y值（32周PMA时的预测成熟度评分）。我们发现，成熟度评分随着PMA的增加而增加，96%的相关系数>0.8。在65名婴儿中，32周PMA的平均实际和预测成熟度评分分别为60和58。当按胎龄分层时，无论检查时婴儿是1周还是数周，30周PMA时的平均实际成熟度评分均为50。因此，低风险早产儿表现出神经成熟率的个体差异。然而，无论神经成熟是在子宫内还是子宫外，音调、反射和反应都以可预测的模式出现。这种测量早产儿神经成熟的独特工具需要专业知识，但不需要技术。它具有令人兴奋的潜力，可以深入了解新兴的中枢神经系统功能和结构如何相互影响，以及中枢神经系统如何从损伤中恢复。（儿科研究65：542-547，2009）
The objective of the study was to follow neuromaturation in preterm infants. From serial exams in 90 low risk very low birthweight infants, each infant's Maturity Scores (the sum of tone, reflex, and response items) were plotted against postmenstrual age (PMA) when examined. Each infant's estimated line of best fit provides two descriptors of that infant's neuromaturation: slope (Individual Maturity Slope) and y-value (Predicted Maturity Score at 32-wk PMA). We found that Maturity Scores increased with PMA, 96% had correlation coefficients >0.8. Mean Actual and Predicted Maturity Scores at 32-wk PMA were 60 and 58, respectively, in 65 infants. When stratified by gestational age, Mean Actual Maturity Score at 30-wk PMA were 50 whether infants were I or several weeks old when examined. Therefore, low risk preterm infants demonstrated individual variability in rate of neuromaturation. Tone, reflexes, and responses nonetheless emerged in a predictable pattern, whether neuromaturation was intrauterine or extrauterine. This unique tool that measures preterm neuromaturation requires expertise but no technology. It has an exciting potential for providing insight into how emerging central nervous system function and structure influence each other, as well as how the central nervous system recovers from injury. (Pediatr Res 65: 542-547, 2009)