经验性抗生素治疗和神经发育非常低出生体重婴儿的结果
Marina P Menegolla1, Rita C Silveira1, Antônio R H Görgen1
1Newborn Section, Child Health and Adolescent Medicine Graduate Program, Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
Neuropediatrics
|March 19, 2025
概括
在怀疑早发性败血症的前72小时内使用经验性抗生素并没有影响非常低出生体重 (VLBW) 婴儿的神经发育. 然而,这些婴儿在新生儿重症监护室 (NICU) 患病率较高.
科学领域:
- 新生儿科学 新生儿科学
- 儿科神经学 儿科神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 早发性败血症是非常低出生体重 (VLBW) 婴儿的一个重大问题.
- 经验性抗生素治疗通常用于疑似败血症,即使有负的血液培养.
- 这种早期的抗生素暴露对神经发育的长期影响尚未完全理解.
研究的目的:
- 评估在出生后72小时内经验性抗生素治疗与VLBW婴儿的神经发育结果之间的关联.
- 为了确定影响神经发育迟缓的因素,在这个脆弱的人群中.
主要方法:
- 一项队列研究包括2014-2021年VLBW婴儿 (24-32周怀孕).
- 婴儿根据接受早期经验性抗生素而被分类.
- 用贝利婴儿发育尺度 (BSID-III) 评估神经发育,年龄在12-36个月之间进行了校正,并应用了倾向分数匹配 (PSM).
主要成果:
- 早期实证抗生素使用与整体神经发育迟缓之间没有发现显著的关联.
- 严重的腹腔内出血是神经发育迟缓的独立预测因素.
- 晚期发作的败血症和支气管肺功能障碍与特定的运动和认知延迟有关.
结论:
- 在怀疑VLBW婴儿早期发作的败血症的前72小时内经验性抗生素治疗与神经发育迟缓没有独立联系.
- 接受早期抗生素的VLBW婴儿经历了更高的新生儿发病率.
- 其他因素,如严重的腹腔内出血,晚发性败血症和支气管肺功能障碍症显著影响神经发育结果.
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