Neurologic Injury in Acidemic Term Infants.
Neurologic Injury in Acidemic Term Infants.
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DOI：
10.1055/s-0036-1597135
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发表时间：
2017-06
影响因子：
2
通讯作者：
Macones GA
中科院分区：
文献类型：
--
作者：
Cahill AG;Mathur AM;Smyser CD;Mckinstry RC;Roehl KA;López JD;Inder TE;Macones GA
确定解剖学上正常的足月婴儿的动脉脐带气（aUCG）pH值是否可以选择磁共振成像（MRI）上确定的脑损伤风险婴儿。我们在8,580名女性的前瞻性队列中进行了巢式病例对照研究。aUCG pH < 7.10的病例在时间、年龄和性别上与aUCG pH ≥ 7.20的对照组相匹配。双变量和多变量分析比较了脑损伤的存在和严重程度。二次分析估计动脉碱过剩或乳酸升高是否与脑损伤相关。55例病例与165例对照相匹配。两组之间的脑损伤无统计学差异（校正比值比[aOR]：1.8 [95%置信区间（CI）：0.7 - 4.4]）。碱过量≥ −8 mEq/L与脑损伤无显著相关性（p = 0.12）。基于动脉乳酸盐升高≥ 4 mmol/L，损伤风险未增加（p = 1.00）。病例在Dubowitz神经学检查的几个领域中明显更可能有异常评分。单独的aUCG酸碱参数不足以识别可能受益于脑MRI以识别损伤的足月儿的临床标志物。
To determine whether arterial umbilical cord gas (aUCG) pH, in anatomically normal term infants, could select infants at-risk for brain injury identified on magnetic resonance imaging (MRI). We performed a nested case-control within a prospective cohort of 8,580 women. Cases, with an aUCG pH < 7.10, were temporally, age, and gender matched to controls with an aUCG pH ≥ 7.20. Bivariable and multivariable analyses compared the presence and severity of brain injury. Secondary analyses estimated whether elevated arterial base excess or lactate were associated with brain injury. Fifty-five cases were matched to 165 controls. There was no statistical difference in brain injury between the groups (adjusted odds ratio [aOR]: 1.8 [95% confidence interval (CI): 0.7 – 4.4]). Base excess ≥ −8 mEq/L was not significantly associated with brain injury (p = 0.12). There was no increase in risk of injury based upon elevation of arterial lactate ≥ 4 mmol ⁄L (p = 1.00). Cases were significantly more likely to have an abnormal score in several domains of the Dubowitz neurological exam. The aUCG acid-base parameters alone are not sufficient clinical markers to identify term infants that might benefit from brain MRI to identify injury.
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影响因子：
48
作者：
Rutherford, Mary;Ramenghi, Luca A.;Edwards, A. David;Brocklehurst, Peter;Halliday, Henry;Levene, Malcolm;Strohm, Brenda;Thoresen, Marianne;Whitelaw, Andrew;Azzopardi, Denis
通讯作者：
Azzopardi, Denis
DOI：
10.3109/14767058.2013.847915
发表时间：
2014-07-01
影响因子：
1.8
作者：
Kayani, Salma I.;Tan, Maw Joo;Alfirevic, Zarko
通讯作者：
Alfirevic, Zarko
DOI：
10.1016/s0002-9378(99)70316-9
发表时间：
1999-10-01
影响因子：
9.8
作者：
Andres, RL;Saade, G;Hankins, GV
通讯作者：
Hankins, GV
影响因子：
120.7
作者：
Crowther, CA;Hiller, JE;Haslam, RR
通讯作者：
Haslam, RR
影响因子：
9.9
作者：
McKinstry, RC;Miller, JH;Neil, JJ
通讯作者：
Neil, JJ