胎儿侧脑室增宽的危险因素及对新生儿早期神经发育的影响

Risk factors of widening the fetus of lateral ventricle and its effect on early neurodevelopment of newborn

目的:研究侧脑室增宽的胎儿母婴相关危险因素,评估其对新生儿神经发育的影响。方法:根据增宽程度,将500例经产前诊断侧脑室增宽胎儿分为轻度组、中度组、重度组。比较3组患儿颅内结构异常、TORCH病毒、侧脑室宽度进展、引产、非孤立型侧脑室增宽发生率;3组胎儿或新生儿发育异常及神经发育异常发生率;新生儿NBNA评分和6个月Gesell评分。结果:重度组患者颅内结构异常、TORCH病毒发生率分别为24.19%和9.35%,均高于中度组的8.47%、7.63%和轻度组的0.31%、1.88%,且中度组均高于轻度组(P<0.05)。重度组、中度组和轻度组胎儿侧脑室宽度进展、引产、非孤立型侧脑室增宽发生率分别为33.87%、19.35%、27.42%,11.86%、6.78%、13.56%和4.06%、4.69%、4.37%,组间比较差异有统计学意义(P<0.05);重度组、中度组和轻度组胎儿或新生儿发育异常及神经发育异常发生率分别为17.74%、22.58%,3.39%、5.08%和0.31%、0.31%,组间比较均有统计学差异(P<0.05)。重度组新生儿NBNA评分和6个月Gesell评分为(36.13±4.51)分和(68.41±5.03)分,低于中度组和轻度组的(37.54±4.93)分、(38.21±5.60)分和(75.82±5.14)分、(79.36±5.28)分,且中度组低于轻度组(P<0.05)。结论:影响胎儿侧脑室增宽的主要因素包括颅内结构异常、TORCH病毒、染色体异常等。胎儿侧脑室增宽将导致产妇引产率增加、胎儿或新生儿发育异常及神经发育异常发生率显著增加。

Objective:To study maternal-infant-related risk factors for widening the fetus in the lateral ventricle,and to assess the impact on postnatal neurodevelopment.Methods:500 cases of fetal prenatal lateral ventricle widening fetuses were divided into mild group,moderate group and severe group according to the degree of fetal lateral ventricle widening.The incidences of intracranial structural abnormalities,TORCH virus,lateral ventricular width progression,labor induction and non-isolated lateral ventricular enlargement,fetal or neonatal developmental abnormalities and neurodevelopmental abnormalities,neonatal NBNA score and 6-month Gesell score were compared among the three groups.Results:The incidence of intracranial structural abnormalities,TORCH virus and intrauterine infections in severe group were 24.19%,9.35%,and 29.03%,respectively,which were higher than those in moderate group and mild group:8.47%,7.63%,10.17%and 0.31%,1.88%,1.56%,and moderate group was higher than mild group(P<0.05).The incidence of lateral ventricular width progression,labor induction,and non-isolated lateral ventricular widening in severe group,moderate group and mild group were 33.87%,19.35%,27.42%and 11.86%,6.78%,13.56%,and 4.06%,4.69%,4.37,the differences between groups were statistically significant(P<0.05).The incidence of fetal or neonatal developmental abnormalities and neurodevelopmental abnormalities in severe group,moderate group and mild group were 17.74%,22.58%and 3.39%,5.08%and 0.31%,0.31%,the differences between groups were statistically significant(P<0.05).The neonatal NBNA score and 6-month Gesell score of severe group were(36.13±4.51)points and(68.41±5.03)points,which were lower than those of moderate group and mild group(37.54±4.93)points,(38.21±5.60)points and(75.82±5.14)points,(79.36±5.28)points,and moderate group was lower than mild group(P<0.05).Conclusion:The influencing factors of fetal lateral ventricular widening are mainly intracranial structural abnormalities,TORCH virus,chromosomal abnormalities,intrauterine infections.Fetal lateral ventricular widening can increase maternal abortion rate,fetal or neonatal developmental abnormalities and neurodevelopmental abnormalities increased significantly.