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P50 Sensory Gating in Infants
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在增长限制干预试验 (GRIT) 中,2岁婴儿福祉:多中心随机对照试验
Lancet (London, England)
|August 11, 2004
概括
过早分娩与延迟分娩的早期分娩在两年内死亡或残疾方面没有显著差异. 然而,延迟分娩可能会减少最早产的婴儿的大脑损伤.
科学领域:
- 产周医学 产周医学
- 新生儿科学 新生儿科学
- 发育儿科 发育儿科
背景情况:
- 改变胎儿损害的早产婴儿的分娩时间是常见的,但在随机试验中没有研究过.
- 临床不确定性经常围绕着在受损胎儿的最佳分娩时间.
研究的目的:
- 为了比较立即分娩与延迟分娩的结果,早产婴儿经历胎儿妥协.
- 评估分娩时间对2岁儿童死亡或残疾的影响.
主要方法:
- 一项随机对照试验,涉及13个欧洲国家的548名孕妇.
- 有胎儿损害的婴儿 (怀孕24-36周) 被随机分为立即或延迟分娩.
- 主要结局:死亡或残疾 (格里菲斯发育系数≤70或严重的运动/感知障碍) 在≥2年. 治疗意向分析.治疗意向分析.
主要成果:
- 2年后的总体死亡或严重残疾为19%的立即分娩和16%的延迟分娩 (OR1.1;95%的CRI为0.7-1.8).
- 这一差异主要是由于怀孕31周之前出生的婴儿的残疾减少,而在延迟怀孕组中 (5%对13%) 的差异较大.
- 在幸存者中没有观察到格里菲斯发育系数中位数的显著差异.
结论:
- 目前为生病的早产婴儿的分娩时间似乎可以将死亡率降到最低,但可能无法最大限度地减少大脑损伤.
- 延迟分娩可能有助于减少最早出生 (31周以下) 婴儿的残疾.
- 证据不支持在终端低氧化症之前提前分娩以改善大脑发育.
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