Prematurity

早产
  • 文章类型: Journal Article
    音乐无处不在,无论是器乐形式还是声乐形式。虽然出生时的言语感知一直是广泛研究语料库的核心,区分器乐或声乐旋律的能力的起源仍未得到很好的研究。在以前的研究中,比较声乐和音乐感知,声音刺激主要与说话有关,包括语言,而不是非语言的歌声。在本研究中,为了更好地将旋律乐器线条与声音进行比较,我们用唱歌作为比较刺激,尽可能地减少两种刺激之间的差异,将语言感知与声乐感知分开。在本研究中,45名新生儿被扫描,10名足月出生婴儿和35名足月龄相同的早产儿(测试时的平均胎龄=40.17周,SD=0.44)使用功能磁共振成像,同时聆听乐器(长笛)演奏或女性声音演唱的五首旋律。要检查基于任务的动态有效连接,我们采用了共激活模式的心理生理相互作用(PPI-CAPs)分析,使用听觉皮层作为种子区域,研究功能磁共振成像任务期间任务驱动的皮质活动调制的时刻变化。我们的发现揭示了特定的条件,动态发生的共激活模式(PPI-CAPs)。在声乐状态下,听觉皮层与感觉运动和显着性网络共同激活,而在仪器状态下,它与视觉皮层和上额叶皮层共同激活。我们的结果表明,声音刺激会引起听觉感知的感觉运动方面,并被处理为更突出的刺激,而仪器条件会激活高阶认知和视觉空间网络。两种听觉刺激的共同神经特征均见于前回和扣带回后回。最后,这项研究增加了有关新生儿早期和专门听觉处理能力的动态大脑连通性的知识,强调动态方法研究新生儿人群脑功能的相关性。
    Music is ubiquitous, both in its instrumental and vocal forms. While speech perception at birth has been at the core of an extensive corpus of research, the origins of the ability to discriminate instrumental or vocal melodies is still not well investigated. In previous studies comparing vocal and musical perception, the vocal stimuli were mainly related to speaking, including language, and not to the non-language singing voice. In the present study, to better compare a melodic instrumental line with the voice, we used singing as a comparison stimulus, to reduce the dissimilarities between the two stimuli as much as possible, separating language perception from vocal musical perception. In the present study, 45 newborns were scanned, 10 full-term born infants and 35 preterm infants at term-equivalent age (mean gestational age at test = 40.17 weeks, SD = 0.44) using functional magnetic resonance imaging while listening to five melodies played by a musical instrument (flute) or sung by a female voice. To examine the dynamic task-based effective connectivity, we employed a psychophysiological interaction of co-activation patterns (PPI-CAPs) analysis, using the auditory cortices as seed region, to investigate moment-to-moment changes in task-driven modulation of cortical activity during an fMRI task. Our findings reveal condition-specific, dynamically occurring patterns of co-activation (PPI-CAPs). During the vocal condition, the auditory cortex co-activates with the sensorimotor and salience networks, while during the instrumental condition, it co-activates with the visual cortex and the superior frontal cortex. Our results show that the vocal stimulus elicits sensorimotor aspects of the auditory perception and is processed as a more salient stimulus while the instrumental condition activated higher-order cognitive and visuo-spatial networks. Common neural signatures for both auditory stimuli were found in the precuneus and posterior cingulate gyrus. Finally, this study adds knowledge on the dynamic brain connectivity underlying the newborns capability of early and specialized auditory processing, highlighting the relevance of dynamic approaches to study brain function in newborn populations.
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  • 文章类型: Journal Article
    背景:传统上,胎龄<34wk和体重<2kg被认为是体外膜氧合(ECMO)的相对禁忌症.缺乏信息可以解释这种独特的早产新生儿群体的结果。这项研究的目的是检查在单个机构<34周接受ECMO的患者的预后。
    方法:对2012年1月至2022年4月在新生儿重症监护病房接受ECMO管理的新生儿进行了单中心回顾性研究。收集特征和结果数据。研究的主要结果是出院时的生存率。次要结果是脑室内出血,缺血性脑损伤,和血栓形成。对数据进行描述性统计分析。
    结果:排除后,纳入107例患者,其中8例患者在<34周开始ECMO。三名(38%)患者,在<34周接受ECMO,与≥34周队列中的14例(14%)相比,发生了脑室内出血。两个(25%),在<34周接受ECMO,在≥34周的患者中,影像学表现出脑缺血征象,与9例(9%)相比,3例(38%)<34周患者发生血栓形成,而≥34周队列中有31例(31%)患者发生血栓形成.<34周队列中有5人(63%)存活出院,在≥34周队列中与61例(61%)相似。
    结论:我们的数据表明EGA<34wk可能不是ECMO的禁忌症,对潜在风险进行适当的咨询。
    BACKGROUND: Traditionally, gestational age <34 wk and weight <2 kg are considered relative contraindications to extracorporeal membrane oxygenation (ECMO). There is a paucity of information that explains the outcomes in this unique population of premature neonates. The purpose of this study is to examine outcomes of patients who undergo ECMO at <34 wk at a single institution.
    METHODS: A single-center retrospective review was performed for neonates managed with ECMO in the neonatal intensive care unit from January 2012 to April 2022. Characteristics and outcome data were collected. The primary outcome studied was survival at discharge. Secondary outcomes were intraventricular hemorrhage, ischemic brain injury, and thrombosis. Data were analyzed with descriptive statistics.
    RESULTS: Following exclusion, 107 patients were included with eight having initiating ECMO at <34 wk. Three (38%) patients, who received ECMO at <34 wk, incurred intraventricular hemorrhages compared to 14 (14%) in the ≥34-wk cohort. Two (25%), who underwent ECMO at <34 wk, exhibited signs of brain ischemia on imaging compared to 9 (9%) in those ≥34 wk, and 3 (38%) patients <34 wk experienced thrombosis compared to 31 (31%) in the ≥34-wk cohort. Five (63%) of those in the <34-wk cohort survived to discharge, similar to 61 (61%) in the ≥34 wk cohort.
    CONCLUSIONS: Our data suggest that EGA <34 wk may not be a contraindication for ECMO, with appropriate counseling of potential risks.
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  • 文章类型: Journal Article
    运动经验塑造婴儿期的认知发展,在生命的前6个月,俯卧位是这样一个至关重要的运动体验。虽然俯卧位的运动好处是有据可查的,它对早期认知能力的影响仍未得到充分探索。这项研究量化了48名足月和3-6个月早产儿的易感运动技能与基于运动的解决问题能力之间的关系。使用艾伯塔省婴儿运动量表的易感域评估俯卧技能。游戏中解决问题的评估用于通过观察如何使用运动动作解决玩具来测量基于运动的问题解决。在所有婴儿中,高级俯卧运动技能与复杂探索技能的增加和低阶探索技能的同时下降相关。早产儿的相关性更强。值得注意的是,在所有婴儿中,俯卧技能增加1分与基于运动的问题解决能力增加1.3分相关.我们的发现为易感游戏对婴儿认知发育的贡献提供了初步证据,提示考虑评估和干预策略。需要进一步的研究来确定俯卧运动技能的延迟获得是否表明早产儿早期解决问题的能力较差。
    Motor experiences shape cognitive development in infancy, with the prone position being one such crucial motor experience in the first 6 months of life. Although the motor benefits of the prone position are well-documented, its influence on early cognitive abilities remains insufficiently explored. This study quantified the relationship between prone motor skills and motor-based problem-solving abilities in 48 full-term and preterm infants aged 3-6 months. Prone skills were assessed using the Alberta Infant Motor Scale\'s prone domain. The Assessment of Problem-Solving in Play was utilized to measure motor-based problem-solving by observing how motor actions were used to solve toys. Advanced prone motor skills were correlated with an increase in sophisticated exploration skills and a concurrent decline in lower order exploration skills in all infants, with correlations being stronger in preterm infants. Notably, a 1-point increase in prone skills was associated with a 1.3-point increase in total motor-based problem-solving abilities in all infants. Our findings provide preliminary evidence for the contribution of prone play to cognitive development in infants, prompting considerations for assessment and intervention strategies. Further research is needed to ascertain if the delayed acquisition of prone motor skills is indicative of poor early problem-solving abilities in preterm infants.
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  • 文章类型: Journal Article
    分析接受光疗的胎盘组织和早产儿的瘦素水平,并评估该人群在光疗后处方被动运动的潜力。
    这种分析,纵向,前瞻性队列研究包括108名产妇及其各自的早产儿。检查的变量包括重量,胎龄,身体质量指数,性别,胎盘组织中的血清瘦素水平,血清胆红素水平,和网织红细胞计数。
    将每组与瘦素阈值进行比较时,在所有评估的时间点,胎盘瘦素水平均观察到统计学上的显着差异(p<0.001)。此外,网织红细胞计数与反弹时间有关(p<0.004)。瘦素/胆红素水平之间没有发现相关性,瘦素/网织红细胞,营养的开始,和BMI/瘦素水平。
    关于瘦素水平的研究结果表明,对接受光疗的早产儿进行被动锻炼可能是可行的,因为这种干预措施不会增加瘦素水平。
    UNASSIGNED: To analyze leptin levels in placental tissue and premature infants undergoing phototherapy and to evaluate the potential for prescribing passive exercise after phototherapy in this population.
    UNASSIGNED: This analytical, longitudinal, prospective cohort study included 108 parturients and their respective premature infants. Variables examined included weight, gestational age, body mass index, sex, serum leptin levels in placental tissue, serum bilirubin levels, and reticulocyte count.
    UNASSIGNED: When comparing each group to a leptin threshold, statistically significant differences were observed at all evaluated time points for placental leptin levels (p < 0.001). Additionally, reticulocyte count decreased in relation to rebound time (p < 0.004). No correlations were found between leptin/bilirubin levels, leptin/reticulocytes, onset of nutrition, and BMI/leptin levels.
    UNASSIGNED: The findings regarding leptin levels suggest that prescribing passive exercises to premature infants undergoing phototherapy may be feasible because this intervention did not increase leptin levels.
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  • 文章类型: Journal Article
    背景:由于不同的SARS-CoV-2变种的优势,COVID-19的严重程度已经演变。我们旨在调查症状患病率的差异以及症状与不良妊娠结局之间的关联,Delta,还有Omicron.
    方法:COVID-19相关症状患病率,本前瞻性研究中注册的5431名孕妇的母体和特定新生儿结局进行了比较,考虑到显性病毒变异.Logistic回归模型分析了特定症状与重症监护病房(ICU)入院或早产之间的关系。
    结果:与野生型/Alpha变体相比,Delta变体的感染导致症状负担增加,并且呼吸道症状的风险最高,疾病的感觉,头痛,和头晕/困倦。Omicron变体感染与呼吸困难和气味/味道变化的风险最低,但鼻塞的风险最高。咳痰,头痛,肌痛,和疲劳与野生型/Alpha和Delta变体的优势期相比。随着野生型/Alpha向Delta变异的进展,新生儿结局恶化。呼吸困难和发热是孕产妇入住ICU和早产的重要预测因素,与疫苗接种状态或感染发作的三个月无关。
    结论:症状负担在Delta期增加,与野生型/Alpha区相比,其妊娠结局更差。在Omicron占主导地位期间,不太严重的症状仍然很高。呼吸困难和发烧可以预测严重的孕产妇疾病。
    BACKGROUND: With the dominance of different SARS-CoV-2 variants, the severity of COVID-19 has evolved. We aimed to investigate the difference in symptom prevalence and the association between symptoms and adverse pregnancy outcomes during the dominance of Wild-type/Alpha, Delta, and Omicron.
    METHODS: COVID-19 related symptom prevalence, maternal and specific neonatal outcomes of 5431 pregnant women registered in this prospective study were compared considering the dominant virus variant. Logistic regression models analyzed the association between specific symptoms and intensive care unit (ICU) admission or preterm birth.
    RESULTS: Infection with the Delta variant led to an increase in the symptom burden compared to the Wild-type/Alpha variant and the highest risk for respiratory tract symptoms, feeling of sickness, headache, and dizziness/drowsiness. An infection with the Omicron variant was associated with the lowest risk of dyspnea and changes in smell/taste but the highest risk for nasal obstruction, expectoration, headaches, myalgia, and fatigue compared to the Wild-type/Alpha and Delta variant dominant periods. With the progression of the Wild-type/Alpha to the Delta variant neonatal outcomes worsened. Dyspnea and fever were strong predictors for maternal ICU admission and preterm birth independent of vaccination status or trimester of infection onset.
    CONCLUSIONS: The symptom burden increased during the Delta period and was associated with worse pregnancy outcomes than in the Wild-type/Alpha area. During the Omicron dominance there still was a high prevalence of less severe symptoms. Dyspnea and fever can predict a severe maternal illness.
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  • 文章类型: Journal Article
    在此符合PRISMA的系统审查中,我们确定并综合了神经影像学和成就评估已用于检查发展规划各方面之间的关系的研究结果,神经发育,在阅读和数学方面的成就。
    47项研究符合纳入标准。大多数人检查了早产(n=32)和产前酒精暴露(n=13)的影响。一些早产研究报告了call骨纤维白质完整性与执行功能和/或成就之间的正相关。在早产儿和足月儿童中,白质特性与认知和学习成绩始终相关.体积研究报告了学术和认知能力与脑岛等区域的白质和灰质体积之间的正相关关系,壳核,和前额叶。功能性MRI研究表明,早产儿的右半球语言处理增加。还报道了与数值能力有关的额顶网络的激活改变。产前酒精暴露研究报告了白质微结构的改变与认知功能和学业成绩的缺陷有关。包括数学,阅读,和词汇技能。体积研究报告大脑减少,小脑,与执行功能测量得分降低相关的皮层下灰质体积,注意,工作记忆,和学习成绩。功能磁共振成像研究证明广泛,弥漫性激活,规范区域的激活减少,并在数字任务期间增加非规范区域的激活。
    大量研究将早产和产前酒精暴露与改变的神经发育过程和次优的学业成绩联系起来。讨论了局限性和对未来研究的建议。
    标识符:DOI10.17605/OSF。IO/ZAN67。
    UNASSIGNED: In this PRISMA-compliant systematic review, we identify and synthesize the findings of research in which neuroimaging and assessments of achievement have been used to examine the relationships among aspects of developmental programming, neurodevelopment, and achievement in reading and mathematics.
    UNASSIGNED: Forty-seven studies met inclusion criteria. The majority examined the impact of prematurity (n = 32) and prenatal alcohol exposure (n = 13). Several prematurity studies reported a positive correlation between white-matter integrity of callosal fibers and executive functioning and/or achievement, and white matter properties were consistently associated with cognitive and academic performance in preterm and full-term children. Volumetric studies reported positive associations between academic and cognitive abilities and white and gray matter volume in regions such as the insula, putamen, and prefrontal lobes. Functional MRI studies demonstrated increased right-hemispheric language processing among preterm children. Altered activation of the frontoparietal network related to numerical abilities was also reported. Prenatal alcohol exposure studies reported alterations in white matter microstructure linked to deficits in cognitive functioning and academic achievement, including mathematics, reading, and vocabulary skills. Volumetric studies reported reductions in cerebral, cerebellar, and subcortical gray matter volumes associated with decreased scores on measures of executive functioning, attention, working memory, and academic performance. Functional MRI studies demonstrated broad, diffuse activation, reduced activation in canonical regions, and increased activation in non-canonical regions during numeric tasks.
    UNASSIGNED: A preponderance of studies linked prematurity and prenatal alcohol exposure to altered neurodevelopmental processes and suboptimal academic achievement. Limitations and recommendations for future research are discussed.
    UNASSIGNED: Identifier: DOI 10.17605/OSF.IO/ZAN67.
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  • 文章类型: Journal Article
    背景:早产儿,特别是那些支气管肺发育不良(BPD),有肺部发育问题的风险。在过去的几十年里,已经使用了肺保护策略,降低慢性肺病的风险。
    目的:评估采用肺保护策略后出生的早产儿的肺功能测试(PFT),并评估该人群中肺功能受损的围产期决定因素。
    方法:前瞻性,观察,单中心研究在高复杂性医院的新生儿病房进行.该研究包括2012年至2014年出生的胎龄小于32周的新生儿,并对他们进行随访,直到他们达到学龄。对于主要结果,两组均建立:无BPD或1级BPD(无BPD/1)和2级或3级BPD(BPD2/3)。
    结果:在327名患者中,116人被包括在内。BPD诊断为49.1%(47),50.9%(29)被列为一级,35.1%(20)被列为二级,14.0%(8)被列为三级。PFT的平均年龄为8.59岁(SD0.90)。平均FEV1%为95.36%(SD13.21),FEV1z评分为-0.36(SD1.12);FVC%为97.53%(SD12.59),FVCz评分为-0.20(SD1.06);FEV1/FVC比率为85.84%(SD8.34),z评分为-0.24(SD1.34)。当比较没有BPD/1和BPD2/3的患者时,我们观察到所有肺功能参数的差异,在调整胎龄后仍然存在。在没有BPD的患者和有1级BPD的患者之间没有观察到PFT的差异。大多数患者(76.7%,89)肺活量测定模式正常,在12.9%(15)中观察到阻塞性模式,限制性模式为9.5%(11),0.9%(1)的患者混合模式。
    结论:与没有BPD/1的早产儿相比,患有BPD2/3的早产儿的所有肺功能参数均下降;这种影响与胎龄无关。在PFT模式改变的BPD患者中,最常见的模式是阻塞,其次是限制性的,然后,混合。
    BACKGROUND: Preterm infants, particularly those with bronchopulmonary dysplasia (BPD), are at risk of lung development problems. Over the last decades, lung protective strategies have been used, decreasing the risk of chronic lung disease.
    OBJECTIVE: To evaluate the pulmonary function test (PFT) of preterm infants born after the introduction of lung protective strategies and to assess perinatal determinants of impaired lung function in this population.
    METHODS: A prospective, observational, single-center study was conducted in the neonatal unit of a high-complexity hospital. The study included newborns with less than 32 weeks gestational age born between 2012 and 2014, who were followed up until they reach school age. For the main outcome, two groups were stablished: no BPD or grade 1 BPD (no BPD/1) and grade 2 or 3 BPD (BPD 2/3).
    RESULTS: Out of 327 patients, 116 were included. BPD was diagnosed in 49.1% (47), with 50.9% (29) classified as grade 1, 35.1% (20) as grade 2, and 14.0% (8) as grade 3. Mean age at PFT was 8.59 years (SD 0.90). Mean FEV1% was 95.36% (SD 13.21) and FEV1 z-score -0.36 (SD 1.12); FVC% 97.53% (SD 12.59) and FVC z-score -0.20 (SD 1.06); FEV1/FVC ratio 85.84% (SD 8.34) and z-score -0.24 (SD 1.34). When comparing patients with no BPD/1 and BPD 2/3, we observed differences in all pulmonary function parameters, which persisted after adjusting for gestational age. No differences in PFT were observed between patients without BPD and those with grade 1 BPD. Most patients (76.7%, 89) had normal spirometry pattern, with obstructive pattern observed in 12.9% (15), restrictive pattern in 9.5% (11), and mixed pattern in 0.9% (1) of patients.
    CONCLUSIONS: Preterm infants with BPD 2/3 showed a decrease in all pulmonary function parameters compared to preterm infants with no BPD/1; an effect that was independent of gestational age. Among patients with BPD who had an altered PFT pattern, the most common pattern was obstructive, followed by restrictive and then, mixed.
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  • 文章类型: Journal Article
    对早产儿视觉认知发育的测试表明,围产期特征与认知之间存在很强的相互作用,学习和整体神经发育进化。通过眼睛跟踪评估对象-位置绑定的预期凝视数据可以预测3岁早产儿的神经发育;鲜为人知,然而,关于生命第一年的早期认知功能及其评估方法。
    当前的研究提供了来自新型评估工具的数据,通过眼动追踪的延迟匹配检索(DMR)范例用于测量视觉工作记忆(VWM)和注意力技能。眼动追踪任务旨在测量婴儿主动定位对象并在线预测对象位置绑定的能力。63名婴儿参加了这项研究,39名早产儿和24名健康足月婴儿-早产儿的矫正年龄为8-9个月,足月婴儿的实际年龄相似。还给婴儿施用了Bayley婴儿和幼儿发育量表。
    对Bayley评分的分析显示两组之间没有显着差异,而眼动追踪数据显示对所有测量值均具有显着的组效应。此外,早产儿的VWM表现明显低于足月。出生体重影响所有感兴趣区域(AOI)的注视时间,VWM的总体表现和认知Bayley分量表的得分。此外,胎儿生长受限(FGR)的早产儿在眼动追踪测量中表现出显著的性能效应,但对他们的Bayley评分没有影响,这证明了眼睛注视数据的高判别值.
    通过眼动追踪测量的视觉工作记忆和注意力是非侵入性的,无痛,短期程序(大约。4分钟)被发现是识别早产和FGR对生命第一年认知发展影响的重要工具。仅BayleyScales可能无法弥补这些不足。确定用于早期神经发育评估和认知功能的工具对于早期支持和干预早产儿的脆弱群体非常重要。考虑到基本的执行功能技能与后来的认知和学术能力之间的关联。
    UNASSIGNED: The testing of visuocognitive development in preterm infants shows strong interactions between perinatal characteristics and cognition, learning and overall neurodevelopment evolution. The assessment of anticipatory gaze data of object-location bindings via eye-tracking can predict the neurodevelopment of preterm infants at the age of 3 years; little is known, however, about the early cognitive function and its assessment methods during the first year of life.
    UNASSIGNED: The current study presents data from a novel assessment tool, a Delayed Match Retrieval (DMR) paradigm via eye-tracking was used to measure visual working memory (VWM) and attention skills. The eye-tracking task that was designed to measure infants\' ability to actively localize objects and to make online predictions of object-location bindings. 63 infants participated in the study, 39 preterm infants and 24 healthy full term infants - at a corrected age of 8-9 months for premature infants and similar chronological age for full term infants. Infants were also administered the Bayley Scales of Infant and Toddler Development.
    UNASSIGNED: The analysis of the Bayley scores showed no significant difference between the two groups while the eye-tracking data showed a significant group effect on all measurements. Moreover, preterm infants\' VWM performance was significantly lower than full term\'s. Birth weight affected the gaze time on all Areas Of Interest (AOIs), overall VWM performance and the scores at the Cognitive Bayley subscale. Furthermore, preterm infants with fetal growth restriction (FGR) showed significant performance effects in the eye-tracking measurements but not on their Bayley scores verifying the high discriminatory value of the eye gaze data.
    UNASSIGNED: Visual working memory and attention as measured via eye-tracking is a non-intrusive, painless, short duration procedure (approx. 4-min) was found to be a significant tool for identifying prematurity and FGR effects on the development of cognition during the first year of life. Bayley Scales alone may not pick up these deficits. Identifying tools for early neurodevelopmental assessments and cognitive function is important in order to enable earlier support and intervention in the vulnerable group of premature infants, given the associations between foundational executive functional skills and later cognitive and academic ability.
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  • 文章类型: Journal Article
    确定出生后足部长度和估计胎龄(EGA)与尼日利亚新生儿出生时确定的宫内生长模式之间的关系。
    以医院为基础,横截面。
    OlabisiOnabanjo大学教学医院,Sagamu,尼日利亚。
    260例出生后48小时内患EGA30-42周的新生儿。
    用Vernier数字卡尺测量出生后足长度(FL),单位为毫米。使用Lubchenco图确定子宫内生长模式。进行Pearson相关和回归分析检验。
    产后足长与子宫内生长模式的关系。
    从30到42周,出生后平均FL与EGA呈强烈正相关(r=0.855,p<0.001)。早产儿的总体平均足长为65.44(6.92)mm,足月新生儿为77.92(4.24)mm。线性回归方程为:EGA=9.43+(0.37×FL),p<0.001。通过FL测量的EGA与胎龄小(SGA)子宫内生长模式呈最高正相关,其次是适合妊娠年龄(AGA)和最小的大妊娠年龄(LGA)分别(r=0.936>0.861>0.666)。
    出生后的足长与估计的胎龄有很好的相关性,在SGA婴儿中相关性最好。
    没有声明。
    UNASSIGNED: To determine the relationship between postnatal foot lengths and estimated gestational age (EGA) in relation to intrauterine growth patterns determined at birth among Nigerian neonates.
    UNASSIGNED: Hospital-based, cross-sectional.
    UNASSIGNED: Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
    UNASSIGNED: 260 neonates with EGA 30- 42 weeks within 48 hours of life.
    UNASSIGNED: Postnatal foot lengths (FL) were measured with Vernier digital calliper in millimetres. The intra-uterine growth pattern was determined using the Lubchenco chart. Pearson correlation and regression analysis tests were performed.
    UNASSIGNED: Postnatal foot length in relation to Intra-Uterine Growth Pattern.
    UNASSIGNED: The mean postnatal FL had a strong positive correlation with the EGA from 30 through 42 weeks (r = 0.855, p < 0.001). The overall mean foot length for preterm neonates was 65.44 (6.92) mm, while that of term neonates was 77.92 (4.24) mm. The linear regression equation was generated as: EGA = 9.43 + (0.37 × FL), p < 0.001. The EGA as measured by FL had the highest positive correlation with Small for Gestational Age (SGA) intra-uterine-growth pattern, followed by Appropriate for Gestational Age (AGA) and least by Large for Gestational Age (LGA) respectively (r = 0.936> 0.861 > 0.666).
    UNASSIGNED: The postnatal foot length correlated well with estimated gestational age, and the correlation was best among SGA infants.
    UNASSIGNED: None declared.
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  • 文章类型: Journal Article
    目的:主要目的是评估坏死性小肠结肠炎(NEC)和自发性肠穿孔(SIP)对32周(WG)之前出生的婴儿在2岁矫正年龄(CA)时的死亡率和神经发育结局的影响。
    方法:我们从EPIPAGE-2队列研究中研究了在32个WG之前出生的NEC或SIP婴儿在2岁时的神经发育。主要结果是死亡或存在中度至重度运动或感觉障碍,定义为中度至重度脑瘫或听力或视力障碍。次要结局是发育延迟,定义为年龄和阶段问卷五个领域中任何一个的得分低于平均值2个SDs。
    结果:在2年\'CA,46%的婴儿患有SIP,34%的NEC婴儿,14%的对照婴儿死亡或有中度至重度感觉运动功能障碍(p<0.01)。这种差异主要是由于SIP或NEC婴儿的住院死亡率增加。SIP婴儿在2岁时的发育延迟比对照组更频繁(70.8%vs44.0%,p=0.02),但NEC和对照组的婴儿相似(49.3%vs44.0%,p=0.5)。在多变量分析中,与对照组相比,发育迟缓的可能性与SIP相关(校正比值比=3.0,95%CI1.0-9.1),但与NEC无关.
    结论:NEC和SIP在2年时显著增加了死亡或感觉运动障碍的风险。SIP还与2年CA时发育迟缓的风险相关。
    OBJECTIVE: The primary objective was to evaluate the impact of necrotising enterocolitis (NEC) and spontaneous intestinal perforation (SIP) on mortality and neurodevelopmental outcomes at 2 years\' corrected age (CA) in infants born before 32 weeks\' gestation (WG).
    METHODS: We studied neurodevelopment at 2 years\' CA of infants with NEC or SIP who were born before 32 WG from the EPIPAGE-2 cohort study. The primary outcome was death or the presence of moderate-to-severe motor or sensory disability defined by moderate-to-severe cerebral palsy or hearing or visual disability. The secondary outcome was developmental delay defined by a score < 2 SDs below the mean for any of the five domains of the Ages and Stages Questionnaire.
    RESULTS: At 2 years\' CA, 46% of infants with SIP, 34% of infants with NEC, and 14% of control infants died or had a moderate-to-severe sensorimotor disability (p < 0.01). This difference was mainly due to an increase in in-hospital mortality in the infants with SIP or NEC. Developmental delay at 2 years\' CA was more frequent for infants with SIP than controls (70.8% vs 44.0%, p = 0.02) but was similar for infants with NEC and controls (49.3% vs 44.0%, p = 0.5). On multivariate analysis, the likelihood of developmental delay was associated with SIP (adjusted odds ratio = 3.0, 95% CI 1.0-9.1) but not NEC as compared with controls.
    CONCLUSIONS: NEC and SIP significantly increased the risk of death or sensorimotor disability at 2 years\' CA. SIP was also associated with risk of developmental delay at 2 years\' CA.
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