極低出生體重早產兒造成腦性麻痺的危險因子之探討

The Risk Factors of Cerebral Palsy in Very Low Birth Weight Prematurity

洪禎雯(Jen-Wen Hung) ； 游敏媛(Min-Yuan Yu) ； 張學文(Hsueh-Wen Chang) ； 洪芳芝(Fang-Chih Hung) ； 梁秋萍(Chau-Peng Leong) ； 黃崇濱(Chung-Bin Huang) ； 黃美涓(May-Kuen Wong)

《中華民國復健醫學會雜誌》 26卷4期 (1998/12) Pp. 181-187

摘要

本研究的目的在了解極低出生體重早產兒導致腦性麻痺之危險因子。我們以問卷及電話訪問收集自民國78年1月至85年12月，於高雄長庚出生之出生體重小於1500公克早產兒159例，臨床評估確定25例為腦性麻痺，分析母親產前狀況、早產兒出生狀況、新生兒併發症及腦部超音波表現等，與早產兒致腦性麻痺的關連。
分析個別因子發現產前出血、子癇前症、出生體重、出生週數、出生方式、第五分鐘Apgar score、呼吸器使用天數、住院天數、呼吸窘迫症、氣管肺部發育不良、開放性動脈導管及腦部超音波異常等統計上有顯著差異。經多變項分析，腦部超音波異常表現及氣管肺部發育不良為顯著且獨立影響因子，對有上述危險因子的極低體重早產兒宜特別注意追蹤治療。

關鍵字

早產兒 ； 腦性麻痺 ； 極低出生體重

並列摘要

nfants with a birth weight less than 1500gm (very low birth weight, VLBW) are more likely to have disabling cerebral palsy(CP). The aim of this study was to identify prenatal, perinatal, postnatal risk factors for CP in VLBW infants and to determine the usefulness of cranial ultrasonographic (us) findings in predicting CP.
The study group comprised 159 VLBW infants born at Chang Gung Memorial Hospital in Kaohsiung in the period from 1989 to 1996. CP was diagnosed via clinical evaluation in twenty-five (15.7%) of these Children. Univariate analysis identified antepartum hemorrhage, pre-eclampsia, birth weight, gestational age, the type of delivery, Apgar score at 5 minutes, ventilation days, hospitalization days, respiratory distress syndrome, bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA) and abnormal cranial US findings as risk factors for CP. Multivariate analysis identified BPD and abnormal cranial US showing grade 3 to 4 intraventricular hemorrhage, periventricular leukomalacia as independent predictors of CP.
These results suggest that abnormal cranial US findings and BPD are useful predictors of CP in VLBW infants.

並列關鍵字

prematurity ； cerebral palsy ； very low birth weight