- 作者：T. Michael O&rsquo ; Shea ; MD ; MPH1 ; moshea@wfubmc.edu ; Elizabeth N. Allred2 ; 3 ; 4 ; Karl C.K. Kuban ; MD ; Sm Epidem5 ; Olaf Dammann ; MD6 ; Nigel Paneth ; MD ; MPH7 ; Raina Fichorova ; MD ; PhD2 ; 8 ; Deborah Hirtz ; MD9 ; Alan Leviton ; MD2 ; 4 ; Extremely Low Gestational Age Newborn (ELGAN) Study Investigators &lowast
- 关键词：BSID-II ; Bayley Scales of Infant Development ; Second Edition ; ELGAN ; Extremely Low Gestational Age Newborn ; GMFCS ; Gross Motor Function Classification System
- 刊名：The Journal of Pediatrics
- 出版年：2012
- 出版时间：March, 2012
- 年：2012
- 卷：160
- 期：3
- 页码：395-401.e4
- 全文大小：204 K
Objective
To evaluate the hypothesis that elevated levels of inflammation-related proteins in early postnatal blood predict impaired mental and motor development in extremely preterm infants.Study design
We measured concentrations of 25 inflammation-related proteins in blood collected on postnatal days 1, 7, and 14 from 939 infants born before 28 weeks gestation. An elevated level was defined as a concentration in the highest quartile for gestational age and day of blood collection. We identified impaired development at age 24 months using the Bayley Scales of Infant Development, Second Edition. The primary outcomes were scores on the Mental Scale or the Motor Scale of <55 (more than 3 SDs below the mean).
Results
For 17 of the 25 inflammation-related proteins, 1 or more statistically significant associations (P < .01) was found between an elevated blood level of the protein and a developmental impairment. Elevations on multiple days were more often associated with developmental impairment than were elevations present for only 1 day. The highest number of predictive elevations was found in day-14 blood.
Conclusion
In extremely preterm infants, elevated levels of inflammation-related proteins in blood collected on postnatal days 7 and 14, especially when sustained, are associated with impaired mental and motor development at age 2 years.