硫酸和高风险队列中缺氧缺血性脑病变的风险
Kathleen C Minor1, Jessica Liu2, Maurice L Druzin1
1Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA.
American journal of obstetrics and gynecology
|April 5, 2024
概括
在孕期高血压疾病的母亲中,产前使用硫酸显著降低了怀孕≥36周出生新生儿缺氧缺血性脑病变 (HIE) 的风险. 这一发现表明在高风险怀孕中对HIE的潜在预防策略.
科学领域:
- 产周医学 产周医学
- 新生儿神经学 新生儿神经学
- 孕产妇和胎儿的医学
背景情况:
- 缺氧性缺血性脑病变 (HIE) 是新生儿发病率和新生儿死亡率的主要原因,在怀孕36周或以上的婴儿中产生.
- 对于HIE的预防性产前治疗存在有限的证据.
- 妊娠高血压障碍 (HDP) 是已知的HIE风险因素,硫酸用于产前的预防.
研究的目的:
- 为了确定HDP的趋势,产前使用硫酸,以及HIE发生率.
- 评估HDP和HIE之间的关联.
- 评估产前硫酸能否减轻患有HDP的母亲产生的新生儿的HIE风险.
主要方法:
- 对2012-2018年活产 (怀孕≥36周) 预期队列的分析.
- 利用加利福尼亚州连接的围产和医疗保健数据.
- 使用后勤回归模型来评估HDP,硫酸和HIE之间的关联.
主要成果:
- 在研究期间,使用HIE,HDP和硫酸的发生率增加.
- HDP与HIE的风险增加有关 (aOR,1.26;P<.001).
- 在患有HDP的母亲中,产前硫酸与HIE几率 (aOR,0.71;P=.03) 和中度/重度HIE (aOR,0.63;P=.03) 的显著降低有关.
结论:
- HDP与HIE风险增加有关,特别是中度/重度病例.
- 产前硫酸显示出与降低HIE风险的显著关联,在新生儿出生于母亲的HDP.
- 研究结果表明,硫酸是孕期婴儿潜在的神经保护剂,需要进一步的临床试验.
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