在婴儿的神经发育结果中,对早产儿视网膜病变进行查
Reem Karmouta1, Jason C Strawbridge1, Seth Langston2
1Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles.
JAMA ophthalmology
|October 26, 2023
概括
公共保险与早产婴儿中神经发育障碍的增加有关,这些早产婴儿接受了早产视网膜病变 (ROP) 查. 抗VEGF治疗在ROP患者中显示出早期神经发育的安全性.
科学领域:
- 新生儿医学 新生儿医学
- 发育儿科 发育儿科
- 公共卫生 公共卫生
背景情况:
- 查早产儿视网膜病变 (ROP) 的早产婴儿表现出各种神经发育结果.
- 预测这些结果具有挑战性,需要对相关风险因素进行研究.
研究的目的:
- 调查社会经济和临床因素与神经发育结果之间的关联,在接受ROP查的早产婴儿的多元多中心队列中.
- 在这个弱势群体中确定神经发育障碍 (NDI) 的预测因素.
主要方法:
- 使用电子医疗记录和美国人口普查局收入数据的回顾性队列研究.
- 纳入标准:符合美国儿科学会指导方针的婴儿使用贝利婴儿和幼儿发展尺度 (BSID) 评估0-36个月之间进行ROP查.年龄调整.
- 收集的数据包括人口统计信息,家庭收入,保险类型,临床因素 (出生体重,心室内出血 [IVH]) 和ROP治疗.
主要成果:
- 公共医疗保险与认知,语言和运动领域中中度至严重的NDI风险显著增加有关 (例如,认知OR3.65,P=8.1 × 10-8).
- 与增加NDI风险相关的临床因素包括出生体重较低,IVH诊断,男性性别和评估时的年龄较大.
- 虽然未经调整的分析表明,激光或抗VEGF治疗的BSID得分较低,但多变量模型没有发现治疗类型和较差的神经发育结果之间的独立关联.
结论:
- 公共保险类型与早产婴儿查ROP的NDI相关,突出了对神经发育的社会经济影响.
- 该研究支持ROP抗VEGF治疗的早期神经发育安全性,因为它与这一队列中的不良结果无关.
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