为了评估发病率,危险因素,北京地区围产期脑卒中的临床特点.
这项多中心前瞻性研究纳入了2019年3月1日至2020年2月29日北京17家代表性孕产妇分娩医院的所有活产。中风的新生儿被分配到研究组。临床数据,包括一般信息,临床表现,和风险因素,被收集。直到出生后18个月,根据年龄和阶段问卷(ASQ)和/或Bayley量表对新生儿进行常规评估.使用卡方进行统计分析,t检验,并使用SPSS26.0版进行逻辑回归分析。
总共,确定27例,北京地区围产期中风的发生率为1/2,660例活产,其中1/5,985为缺血性卒中,1/4,788为出血性卒中。72h内出现急性症状性卒中并惊厥17例(62.96%)(10例,37.04%)是最常见的演讲。10例患者没有表现出神经系统症状,并在因非神经系统疾病住院后通过常规颅骨超声检查发现中风。风险因素包括基本平价,胎盘或子宫早剥/急性绒毛膜羊膜炎,宫内窘迫,窒息,和严重感染。在研究小组中,11.1%(3/27)的患者有不良的神经发育结局。研究组患者在沟通中的ASQ评分低于对照组,gross,和精细的电机尺寸。
北京围产期脑卒中的发病率与其他国家一致。对有危险因素的婴儿进行常规神经影像学检查可以识别更多患者的无症状中风。患有中风的患者可能会有神经系统后遗症;因此,早期发现,治疗,定期随访有利于改善他们的康复结果。
To assess the incidence, risk factors, and clinical characteristics of perinatal stroke in Beijing.
This multicenter prospective study included all the live births from 17 representative maternal delivery hospitals in Beijing from March 1, 2019 to February 29, 2020. Neonates with a stroke were assigned to the study group. Clinical data, including general information, clinical manifestations, and risk factors, were collected. Up until 18 months after birth, neonates were routinely assessed according to the Ages and Stages Questionnaire (ASQ) and/or the Bayley scale. Statistical analysis was done using the chi-squared, t-tests, and logistic regression analysis using SPSS version 26.0.
In total, 27 cases were identified and the incidence of perinatal stroke in Beijing was 1/2,660 live births, including 1/5,985 for ischemic stroke and 1/4,788 for hemorrhagic stroke. Seventeen cases (62.96%) of acute symptomatic stroke and convulsions within 72 h (10 cases, 37.04%) were the most common presentations. Ten patients showed no neurological symptoms and were found to have had a stroke through routine cranial ultrasonography after being hospitalized for non-neurological diseases. The risk factors include primiparity, placental or uterine abruption/acute chorioamnionitis, intrauterine distress, asphyxia, and severe infection. In the study group, 11.1% (3/27) of patients had adverse neurodevelopmental outcomes. The patients in the study group had lower scores for the ASQ than those in the control group in the communication, gross, and fine motor dimensions.
The incidence of perinatal stroke in Beijing was consistent with that in other countries. Routine neuroimaging of infants with risk factors may enable identification of asymptomatic strokes in more patients. Patients who have suffered from a stroke may have neurological sequelae; therefore, early detection, treatment, and regular follow-ups are beneficial for improving their recovery outcomes.