胎児の成長制限と小学校の成績との関連
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Roshan John Selvaratnam1,2, Euan Morrison Wallace1,2, Rory Wolfe3
1The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.
JAMA
|July 13, 2021
まとめ
胎児の成長制限 (FGR) の疑いがある妊娠年齢 (SGA) に対して重度の小児の出産は,学校での成績の悪化と関連しています. しかし,正常な成長の乳児におけるFGRの疑いによる早期出産は,学校の成績に悪影響を及ぼさなかった.
科学分野:
- 産前医学
- 発達に関する小児科
- 公衆衛生
背景:
- 胎児の成長制限 (FGR) の疑いがある場合の間に合った出産は,早産の合併症に対する死産リスクのバランスをとります.
- FGRを疑う多くの乳児は正常な成長を示し,出産の決定を複雑にする.
研究 の 目的:
- 疑われるFGRと,その後の小児の学校での成績との関連を調査する.
- 妊娠年齢 (SGA) に対して小さかったか,または正常な成長であったかによるアウトカムを区分する.
主な方法:
- オーストラリアのビクトリア州 (2003年−2013年) での705,937人の出産 (妊娠32週以上) の経後コホート研究を分析した.
- データは7年生までの 発達と教育に関するテストスコアと関連付けられました
- 乳児は,FGRの疑い,イアトロゲン分娩,および妊娠年齢 (SGA) ステータス (出生体重< 3 番目の百分位または> 10 番目の百分位) によって分類されました.
主要な成果:
- FGRが疑われない重度のSGAを患った乳児は,FGRが疑われない重度のSGAを患った乳児と比較して,発達と教育の結果が悪かった.
- 具体的には,これらの乳児は,学校に入学時に発達不良の結果と3,5,7年生の教育不良の結果のリスクが増加しました.
- 対照的に,FGRが疑われる正常な成長の乳児は,早めの妊娠にもかかわらず,FGRが疑われない正常な成長の乳児と比較して,学校での成績で有意な差異を示さなかった.
結論:
- 重度のSGAの乳児におけるFGRの疑いに対するIatrogenic出産は,学校での不良結果と関連しています.
- 正常な成長の乳児では,FGRの疑いによるイアトロゲン分娩は,学校の成績に悪影響を及ぼさないようです.
- これらの発見は,疑わしいFGRの配送を検討する際の成長状態の差別化の重要性を強調しています.
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