早产儿脑室内出血的短期预后

Manizheh Mostafa-Gharehbaghi, N. Khanzadeh, M. Mahallei, Fatemeh Ghatre Samani
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摘要

背景:脑室内出血(IVH)仍然是妊娠32周前出生的极早产儿的严重并发症。IVH与出血性脑积水和随后的神经发育障碍密切相关。目的:本研究评估IVH在早产儿发生时间的短期预后。方法:本研究招募了2019年9月至2020年10月在伊朗西北部一家教学转诊大学医院就诊的IVH早产儿。我们随访了40名IVH新生儿,并在6个月和12个月时评估他们的神经发育情况。我们将延迟IVH定义为生命第二周后首次检测到IVH。比较IVH发生时间对神经发育的影响。结果:40例IVH纳入本研究,其中4例因出院前死亡而被排除。患者平均胎龄29.3±2.3周,出生体重1361±564 g。31例新生儿(86.1%)在出生后第一周发生脑室出血,5例新生儿(13.9%)延迟发生脑室出血。出生第1周IVH患儿中有14例(45.1%)和2例(40%)在出生后6个月出现神经发育迟缓(P = 0.37)。在出生第一周发生IVH的婴儿中,有8例(25.8%)在出生后12个月被诊断为神经发育迟缓,而IVH延迟的婴儿中有1例(20%)在出生后12个月被诊断为神经发育迟缓(P = 0.17)。结论:脑室内出血是早产儿神经发育迟缓的重要原因,其发生时间与IVH结局无显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Short-Term Outcome of Preterm Infants with Intraventricular Hemorrhage
Background: Intra-ventricular hemorrhage (IVH) remains a severe complication of very preterm infants born before 32 weeks of gestation. IVH is strongly associated with post-hemorrhagic hydrocephalus and subsequent neurodevelopmental disabilities. Objectives: This study evaluated the short-term outcome of IVH in preterm infants concerning its occurrence time. Methods: This study enrolled preterm newborn infants with IVH visiting a teaching referral university hospital in the North West of Iran from September 2019 to October 2020. We followed 40 neonates with IVH and evaluated their neurodevelopment at 6 and 12 months. We defined delayed IVH as IVH detected the first time after the second week of life. The neurodevelopmental outcome was compared with respect to the time of IVH occurrence. Results: Forty cases of IVH were enrolled in this study, of whom 4 cases were excluded because of death before hospital discharge. The studied patients' mean gestation age and birth weight were 29.3 ± 2.3 weeks and 1361 ± 564 g, respectively. Intra-ventricular hemorrhage occurred in the first week of life in 31 neonates (86.1%) and delayed in 5 neonates (13.9%). The neurodevelopmental delay was detected at 6 months after birth in 14 infants (45.1%) with IVH in the first week of life and 2 (40%) cases with delayed IVH (P = 0.37). Neurodevelopmental delay was diagnosed at 12 months after birth in 8 infants (25.8%) with IVH in the first week of life and 1 infant (20%) with delayed IVH (P = 0.17). Conclusions: Intra-ventricular hemorrhage is an essential cause of neurodevelopmental delay in preterm infants, and there is no significant difference in IVH outcomes with respect to the time of IVH occurrence.
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