带血的pH值,阿帕格得分和注意力缺陷/多动障碍
Mette Vestergård Pedersen1,2, Morten Søndergaard Lindhard2,3, Dag Moster4,5
1Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
JAMA network open
|January 26, 2026
概括
围产期缺氧,通过低的阿帕格评分和带pH值来表明,与注意力缺陷/多动症 (ADHD) 几率的增加有关. 标准化任何一种措施都会否定这种关联,这表明组合指标对于风险评估至关重要.
科学领域:
- 神经科学是一个神经科学.
- 儿科 儿科 儿科
- 公共卫生 公共卫生
背景情况:
- 围产期缺氧是神经发育障碍的已知危险因素,包括注意力缺陷/多动症障碍 (ADHD).
- 准确评估围产期缺氧需要评估临床 (Apgar评分) 和生化 (带血pH) 标记.
- 以前的研究往往仅依赖于阿普加尔评分,可能低估了与缺氧相关的风险.
研究的目的:
- 为了确定暴露于围产期缺氧的新生儿,使用APGAR评分和带血pH标准的结合.
- 调查这种联合缺氧评估与随后的ADHD发展之间的关联.
主要方法:
- 一项全国性的丹麦队列研究包括从2004年至2018年的单独新生儿 (妊娠年龄≥35周).
- 低氧被归类为5分钟的阿巴格评分 (0-3,4-6,7-10) 和带血pH值 (<7.10,7.10-7.19,≥7.20) 的组合.
- 根据医院诊断和药物处方来确定ADHD的结果,并使用调整的几率比率和多重归算来分析数据.
主要成果:
- 这项研究分析了819,658名新生儿;0.3%的新生儿的Apgar分数 (0-3) 和pH值都很低 (<7.10).
- 对于pH <7.20和Apgar <7的组合,观察到ADHD的几率增加,最显著的是Apgar 0-3和pH <7.10 (aOR=1.86).
- 如果pH值≥7.20时,Apgar评分和ADHD之间没有联系,如果Apgar评分≥7.20时,pH值和ADHD之间也没有联系.
结论:
- 围产期缺氧的联合临床和生化指标 (低Apgar分数和低带pH值) 与ADHD的几率增加有关.
- 当Apgar分数或pH值正常时,ADHD风险没有增加,这表明这些综合措施对于识别有风险的新生儿至关重要.
- 这一发现强调了全面围产期评估对于预测ADHD等神经发育结果的重要性.
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