合併症のない独角性双生児:神経発達に関する洞察と影響
D Casati1, M M Lanna1, D Consonni2
1Fetal Therapy Unit "U. Nicolini", Buzzi Children's Hospital, University of Milan, Milan, Italy.
まとめ
軽度の神経発達障害は,合併症のない独角性双生児 (MCDA) で一般的であり,自閉症スペクトル障害 (ASD) のリスクが高くなります. 早期発見と標準化されたフォローアップは 最適な結果を得るために不可欠です
科学分野:
- 生理学
- 発達に関する小児科
- 双子研究
背景:
- モノコリアン・ダイアミニオティック (MCDA) 双子は,胎盤を共有しているため,独特の生理学的適応を示します.
- 合併症のないMCDA双子の長期的な神経発達結果はさらなる調査を必要としています.
- 神経発達リスクの早期発見は 適切な介入に不可欠です
研究 の 目的:
- 3歳までの不合併症のMCDA双子の神経発達を評価する.
- この集団における神経発達障害 (NDI) に関する危険因子を特定する.
- 将来の研究とフォローアッププロトコルのための勧告を提案する.
主な方法:
- 妊娠34週間の間に生まれた不合併症のMCDA双子の観察コホート研究 (n=138).
- ベイリースケールによる神経発達評価と1,2,3年の神経学的評価
- NDIと生後/環境要因との関連を分析するための多変数ロジスティック回帰モデル.
主要な成果:
- 平均ベイリースコアはシングルトンと同等だったが,NDIは軽度で29. 0%で,NDIは重度で5. 8%であった.
- 自閉症スペクトル障害 (ASD) を含む行動障害は,乳児の11. 6%で診断されました.
- 呼吸器障害症候群は軽度のNDIを予測し,女性の性別,より高い妊産婦年齢,より高い社会文化的な地位は保護的であった.
結論:
- 軽度の神経発達障害とASDの発生率は,合併症のないMCDAの双子で一般的です.
- NDIの早期発見は長期的な影響を軽減するために重要です.
- 標準化された神経発達フォローアッププロトコルは,MCDAの双子のために推奨されます.
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