妊娠 29 周前出生婴儿的母亲糖尿病与神经发育结果。

IF 3.9 2区医学 Q1 PEDIATRICS

Journal of Pediatrics Pub Date : 2024-09-19 DOI:10.1016/j.jpeds.2024.114319

Adetokunbo Akinseye MBBS , Christy Pylypjuk MD, MSc , Diane Moddemann MD, MEd , Jehier Afifi MBBCh, MSc , Rudaina Banihani MD, MHPE , Khalid Aziz MBBS, MEd (IT) , Dianna Wang MD , Mary Seshia MBChB

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引用次数: 0

摘要

研究目的比较在加拿大出生的婴儿的神经发育结果研究设计：这是一项使用加拿大新生儿网络（CNN）和加拿大新生儿随访网络（CNFUN）数据库进行的回顾性队列研究。出生婴儿结果在 13,988 名符合条件的婴儿中，55% 接受了神经发育随访评估。与未患糖尿病的婴儿相比，患 NDI 的几率更高（aOR 1.09 (95% CI 1.08-1.54)）；患 sNDI 的几率没有差异（aOR 1.07 (95% CI 0.84-1.36)）。母婴糖尿病患儿的语言和运动发育迟缓更为常见：结论：妊娠期小于 29 周、在宫内感染糖尿病的婴儿出现 NDI、语言或运动迟缓的比例较高。未来的研究需要确定这些发现的病因和临床意义。

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Maternal Diabetes and Neurodevelopmental Outcomes of Infants Born Before 29 Weeks’ Gestation

Objective

To compare the neurodevelopmental outcomes of infants born at <29 weeks’ gestation and exposed to diabetes in pregnancy with those unexposed.

Study design

This was a retrospective cohort study using the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network databases. Infants born <29 weeks’ gestation and admitted to a level 3 neonatal intensive care unit from 2009 through 2018 who had neurodevelopmental assessments at 18-24 months corrected age were eligible. The 2 primary outcomes were as follows: (1) Neurodevelopmental impairment (NDI) (≥1 of Bayley-III scores < 85 in any domain, cerebral palsy, or vision or hearing impairment); and (2) significant NDI (sNDI) (≥1 of Bayley-III scores < 70 in any domain, cerebral palsy Gross Motor Function Classification System ≥ 3, bilateral blindness, or need for hearing aids or cochlear implants). Secondary outcomes were the individual components of NDI and sNDI. Adjusted odds ratios with 95% CIs were calculated to determine outcomes between groups.

Results

Of 13 988 eligible infants, 55% attended neurodevelopmental follow-up assessments. Infants exposed to diabetes had increased odds of NDI compared with those unexposed (aOR 1.09 (95% CI 1.08-1.54); there was no difference in sNDI (aOR 1.07 (95% CI 0.84-1.36). Language and motor delays were more common in those exposed to maternal diabetes.

Conclusions

Higher rates of NDI, language, or motor delays were present in infants born at <29 weeks' gestation exposed to diabetes in utero. Future research is needed to determine the etiology and clinical significance of these findings.

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来源期刊

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.