■先兆子痫对胎儿发育有直接影响,并可能影响产后健康,胎儿生长受限(FGR)通常与先兆子痫同时发生。先兆子痫诊断有和没有FGR后早产的儿童的发育没有得到很好的表征。
■在一组非常早产的婴儿中检查先兆子痫和FGR与发育和/或行为结局的关联。
■在这项队列研究中,2014年4月至2016年6月,在9个美国大学附属新生儿重症监护病房(NICU)纳入了前瞻性新生儿神经行为和极早产儿结局研究的婴儿.符合条件的婴儿在妊娠30周前出生。排除婴儿的任何主要先天性异常和年龄小于18岁的母亲或影响提供知情同意能力的认知障碍。从2023年11月至2024年1月进行数据分析。
■极早产儿的先兆子痫和FGR。
■Bayley-III认知,电机,语言得分低于85(-1SD)表示发育迟缓。儿童行为清单/学龄前1.5-5T分数大于或等于64的内化,外部化,或全部问题表明临床重要性。
■在704名婴儿中,529(平均[SD]胎龄,27.0[1.9]周;287名男性[54.3%])在24个月的随访中进行了研究。共有94名婴儿母亲患有先兆子痫(23.2%),46名婴儿(8.7%)有FGR。在调整后的模型中,先兆子痫与贝利-III(认知,B=3.43[95%CI,-0.19至6.66];语言,B=3.92[95%CI,0.44至7.39];运动,B=1.86[95%CI,-1.74至5.47])或儿童行为清单/学龄前1.5-5(内化,B=-0.08[95%CI,-2.58至2.73];外部化,B=0.69[95%CI,-1.76至3.15];总计,B=0.21[95%CI,-2.48至2.91])结果。FGR与显著较低的Bayley-III评分相关(认知,B=-8.61[95%CI,-13.33至-3.89];语言,B=-8.29[95%CI,-12.95至-3.63];马达,B=-7.60[95%CI,-12.40至-2.66]),不管先兆子痫的状态。
■在这项早产儿队列研究中,先兆子痫与发育和/或行为结局无关,但是FGR的婴儿可能容易出现发育迟缓。这些发现表明了未来的研究领域,可以分别和一起了解先兆子痫和FGR在早产儿早期儿童发育中的作用。
UNASSIGNED: Preeclampsia has direct influences on a developing fetus and may impact postnatal health, and fetal growth restriction (FGR) is often seen co-occurring with preeclampsia. The development of children born very preterm after preeclampsia diagnosis with and without FGR is not well characterized.
UNASSIGNED: To examine the associations of preeclampsia and FGR with developmental and/or behavioral outcomes in a cohort of very preterm infants.
UNASSIGNED: In this cohort study, infants in the prospective Neonatal Neurobehavior and Outcomes in Very Preterm Infants study were enrolled between April 2014 and June 2016 from 9 US university-affiliated neonatal intensive care units (NICUs). Eligible infants were born before 30 weeks\' gestation. Infants were excluded for any major congenital anomalies and for maternal age younger than 18 years or cognitive impairment impacting the ability to provide informed consent. Data analysis was performed from November 2023 to January 2024.
UNASSIGNED: Maternal preeclampsia and FGR in very preterm infants.
UNASSIGNED: The Bayley-III cognition, motor, and language scores less than 85 (-1 SD) indicated developmental delay. Child Behavior Checklist/Preschool 1.5-5 T-scores greater than or equal to 64 for internalizing, externalizing, or total problems indicated clinical importance.
UNASSIGNED: Of 704 infants enrolled, 529 (mean [SD] gestational age, 27.0 [1.9] weeks; 287 male [54.3%]) were studied at 24-month follow-up. A total of 94 infants\' mothers had preeclampsia (23.2%), and 46 infants (8.7%) had FGR. In adjusted models, preeclampsia was not associated with Bayley-III (cognitive, B = 3.43 [95% CI, -0.19 to 6.66]; language, B = 3.92 [95% CI, 0.44 to 7.39]; motor, B = 1.86 [95% CI, -1.74 to 5.47]) or Child Behavior Checklist/Preschool 1.5-5 (internalizing, B = -0.08 [95% CI, -2.58 to 2.73]; externalizing, B = 0.69 [95% CI, -1.76 to 3.15]; total, B = 0.21 [95% CI, -2.48 to 2.91]) outcomes. FGR was associated with significantly lower Bayley-III scores (cognitive, B = -8.61 [95% CI, -13.33 to -3.89]; language, B = -8.29 [95% CI, -12.95 to -3.63]; motor, B = -7.60 [95% CI, -12.40 to -2.66]), regardless of preeclampsia status.
UNASSIGNED: In this cohort study of preterm infants, preeclampsia was not associated with developmental and/or behavioral outcomes, but infants with FGR may be prone to developmental delays. These findings suggest future areas of research for understanding the roles of preeclampsia and FGR separately and together in early child development for preterm infants.