{"title":"接受积极护理的 22 至 25 周出生婴儿的神经系统预后和相关围产期因素","authors":"Yu Ariyoshi, Takayuki Iriyama, Takahiro Seyama, Seisuke Sayama, Eriko Yano, Kensuke Suzuki, Taiki Samejima, Mari Ichinose, Masatake Toshimitsu, Kenbun Sone, Atsushi Ito, Yoshihiko Shitara, Keiichi Kumasawa, Kohei Kashima, Satsuki Kakiuchi, Yasushi Hirota, Naoto Takahashi, Yutaka Osuga","doi":"10.1038/s41372-024-02093-0","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To elucidate the outcomes of periviable infants receiving active care (AC) and explore perinatal factors associated with neurodevelopmental outcomes.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This is a single-center retrospective study on infants born at 22–25 weeks of gestation, all of whom received AC. A developmental quotient (DQ) ≥ 85 at corrected 18 months was judged as normal.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Fifty-seven infants were included in the study. The survival rates at discharge were 83%, 86%, 93%, and 93% at 22, 23, 24, and 25 gestational weeks, respectively. The overall percentage of normal DQ was 26/47 (55%). Acidemia in the arterial blood gas measured within 6 h after birth was identified as a factor significantly associated with subnormal DQ.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Not only high survival rates, but also favorable neurodevelopmental outcomes may be achieved by AC in periviable infants. Moreover, impaired neurodevelopmental outcomes may be associated with early postnatal acidemia following initial resuscitation.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"50 1","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Neurological outcomes and associated perinatal factors in infants born between 22 and 25 weeks with active care\",\"authors\":\"Yu Ariyoshi, Takayuki Iriyama, Takahiro Seyama, Seisuke Sayama, Eriko Yano, Kensuke Suzuki, Taiki Samejima, Mari Ichinose, Masatake Toshimitsu, Kenbun Sone, Atsushi Ito, Yoshihiko Shitara, Keiichi Kumasawa, Kohei Kashima, Satsuki Kakiuchi, Yasushi Hirota, Naoto Takahashi, Yutaka Osuga\",\"doi\":\"10.1038/s41372-024-02093-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Objectives</h3><p>To elucidate the outcomes of periviable infants receiving active care (AC) and explore perinatal factors associated with neurodevelopmental outcomes.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>This is a single-center retrospective study on infants born at 22–25 weeks of gestation, all of whom received AC. A developmental quotient (DQ) ≥ 85 at corrected 18 months was judged as normal.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Fifty-seven infants were included in the study. The survival rates at discharge were 83%, 86%, 93%, and 93% at 22, 23, 24, and 25 gestational weeks, respectively. The overall percentage of normal DQ was 26/47 (55%). Acidemia in the arterial blood gas measured within 6 h after birth was identified as a factor significantly associated with subnormal DQ.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusions</h3><p>Not only high survival rates, but also favorable neurodevelopmental outcomes may be achieved by AC in periviable infants. Moreover, impaired neurodevelopmental outcomes may be associated with early postnatal acidemia following initial resuscitation.</p>\",\"PeriodicalId\":16690,\"journal\":{\"name\":\"Journal of Perinatology\",\"volume\":\"50 1\",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Perinatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1038/s41372-024-02093-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41372-024-02093-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Neurological outcomes and associated perinatal factors in infants born between 22 and 25 weeks with active care
Objectives
To elucidate the outcomes of periviable infants receiving active care (AC) and explore perinatal factors associated with neurodevelopmental outcomes.
Methods
This is a single-center retrospective study on infants born at 22–25 weeks of gestation, all of whom received AC. A developmental quotient (DQ) ≥ 85 at corrected 18 months was judged as normal.
Results
Fifty-seven infants were included in the study. The survival rates at discharge were 83%, 86%, 93%, and 93% at 22, 23, 24, and 25 gestational weeks, respectively. The overall percentage of normal DQ was 26/47 (55%). Acidemia in the arterial blood gas measured within 6 h after birth was identified as a factor significantly associated with subnormal DQ.
Conclusions
Not only high survival rates, but also favorable neurodevelopmental outcomes may be achieved by AC in periviable infants. Moreover, impaired neurodevelopmental outcomes may be associated with early postnatal acidemia following initial resuscitation.
期刊介绍:
The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development.
The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.