Prolonged oligohydramnios and the adverse composite outcome of death or severe neurodevelopmental impairment at 3 years of age in infants born at 22–29 gestational weeks

IF 2.2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Mitsuhiro Haga , Eri Nishimura , Ayumi Oshima , Naoyuki Miyahara , Shuntaro Oka , Yukiko Motojima , Kana Saito , Kanako Itoh , Masayo Kanai , Kazuhiko Kabe , Sumiko Era , Shinichiro Yabe , Akihiko Kikuchi , Fumihiko Namba
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Abstract

Objective

To investigate the association between prolonged oligohydramnios and a composite outcome of death or severe neurodevelopmental impairment (NDI) at 3 years of age.

Methods

This single-center retrospective cohort study enrolled infants born at 22–29 weeks of gestational age without major congenital anomalies. The patients were classified into three groups depending on the existence and duration of oligohydramnios: no/non-prolonged oligohydramnios (no or 0–7 days of oligohydramnios), prolonged oligohydramnios (8–14 days), and very prolonged oligohydramnios (> 14 days). The primary outcome was a composite of death or severe NDI, which was defined as severe cerebral palsy, developmental delay, severe visual impairment, or deafness at age 3.

Results

Out of the 843 patients, 784 (93 %), 30 (3.6 %), and 29 (3.4 %) were classified into the no/non-prolonged, prolonged, and very prolonged oligohydramnios groups, respectively. After excluding patients lost to follow-up, the adverse composite outcome at 3 years of age was observed in 194/662 (29 %), 7/26 (27 %), and 8/23 (35 %) in the corresponding groups. The composite outcome showed no significant trend with the duration of oligohydramnios (P = 0.70). In a logistic regression model controlling the known predictors of gestational age, birth weight, small-for-gestational-age, male sex, multiple pregnancy, hypertensive disorders of pregnancy, antenatal corticosteroids, and the number of family–social risk factors, the duration of oligohydramnios was not independently associated with the composite outcome; odds ratio 1.3 (95 % confidence interval, 0.78–2.0).

Conclusion

Prolonged oligohydramnios was not associated with the composite outcome of death or severe NDI at 3 years of age.

孕 22-29 周出生的婴儿长时间少尿与 3 岁时死亡或严重神经发育障碍的不良综合结果
方法 这项单中心回顾性队列研究招募了胎龄 22-29 周出生且无重大先天性畸形的婴儿。根据少水妊娠的存在和持续时间将患者分为三组:无/非长期少水妊娠(无少水妊娠或少水妊娠持续 0-7 天)、长期少水妊娠(8-14 天)和非常长期少水妊娠(> 14 天)。结果 在 843 名患者中,784 人(93%)、30 人(3.6%)和 29 人(3.4%)分别被归入无/未延长、延长和极延长少水妊娠组。在排除失去随访的患者后,194/662(29%)、7/26(27%)和 8/23(35%)名患者在 3 岁时出现了不良的综合结果。综合结果与少孕期持续时间无明显趋势(P = 0.70)。在一个逻辑回归模型中,在控制了已知的预测因素(胎龄、出生体重、小于胎龄、男性、多胎妊娠、妊娠高血压疾病、产前皮质类固醇和家庭社会风险因素的数量)后,少尿症持续时间与综合结果无独立关联;几率比 1.3(95 % 置信区间,0.78-2.0)。结论长期少尿与 3 岁时死亡或严重 NDI 的综合结果无关。
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来源期刊
Early human development
Early human development 医学-妇产科学
CiteScore
4.40
自引率
4.00%
发文量
100
审稿时长
46 days
期刊介绍: Established as an authoritative, highly cited voice on early human development, Early Human Development provides a unique opportunity for researchers and clinicians to bridge the communication gap between disciplines. Creating a forum for the productive exchange of ideas concerning early human growth and development, the journal publishes original research and clinical papers with particular emphasis on the continuum between fetal life and the perinatal period; aspects of postnatal growth influenced by early events; and the safeguarding of the quality of human survival. The first comprehensive and interdisciplinary journal in this area of growing importance, Early Human Development offers pertinent contributions to the following subject areas: Fetology; perinatology; pediatrics; growth and development; obstetrics; reproduction and fertility; epidemiology; behavioural sciences; nutrition and metabolism; teratology; neurology; brain biology; developmental psychology and screening.
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