极低体重儿振幅整合脑电图异常的影响因素

Influencing factors of abnormal amplitude integrated electroencephalogram in extremely low birth weight infants

目的分析极低体重儿振幅整合脑电图(aEEG)异常的有关影响因素。方法选取2022年1月至2023年1月九江市妇幼保健院收治的80例出生周龄≤32^(+6)周的极低体重儿(体重≤1500 g)作为研究对象,出生后给予常规干预,于纠正胎龄32+周时完善aEEG检查,统计aEEG异常情况;另收集胎次等一般资料,以多因素logistic回归分析模型分析极低体重儿aEEG异常的影响因素。结果80例患儿中,共有39例发生aEEG异常,发生率为48.75%(39/80)。单因素分析显示,不同性别、胎次、生产方式、母流产史、母孕期糖尿病的极低体重儿的aEEG异常率比较,差异无统计学意义(P>0.05);不同出生体重、胎盘胎膜与脐带异常、绒毛膜羊膜炎、宫内窘迫、酸中毒的极低体重儿的aEEG异常率比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,出生体重<1000 g(β=1.905,95%CI:2.461~18.330)、有胎盘胎膜与脐带异常(β=1.549,95%CI:1.784~12.414)、有绒毛膜羊膜炎(β=1.825,95%CI:2.338~16.443)、有宫内窘迫(β=1.347,95%CI:1.521~9.726)、有酸中毒(β=0.913,95%CI:1.012~6.132)为极低体重儿发生aEEG异常的危险因素(OR>1,P<0.05)。结论极低体重儿的aEEG异常发生率较高,而出生体重<1000 g、有胎盘胎膜与脐带异常、有绒毛膜羊膜炎等为患儿aEEG异常发生的危险因素,提示aEEG可于早期对患儿的神经系统发育情况进行评估。

Objective To analyze the relevant influencing factors of amplitude integrated electroencephalogram(aEEG)abnormalities in extremely low and ultra-low birth weight infants.Methods A total of 80 cases of ultra-low and extremely low birth weight infants(weight≤1500 g)admitted to Jiujiang Maternal and Child Health Hospital from January 2022 to January 2023,with a gestational age of≤32^(+6) weeks,were selected as the research subjects.Routine intervention was given after birth,and aEEG examinations were completed at the time of correcting gestational age of 32+weeks,and the abnormal situation of aEEG was statistically analyzed;Collect general data such as birth order and analyze the influencing factors of aEEG abnormalities in extremely low and ultra-low birth weight infants using a multivariate logistic regression analysis model.Results Among the 80 patients,a total of 39 had abnormal aEEG,with an incidence rate of 48.75%(39/80).The univariate analysis showed that there was no significant difference in the abnormal rate of aEEG between very low and very low birth weight infants with different sex,parity,mode of production,history of maternal abortion,maternal diabetes during pregnancy(P>0.05).There were statistically significant differences in the abnormal rate of aEEG between extremely low and ultra-low birth weight infants with different birth weights,placental and fetal abnormalities,chorioamnionitis,intrauterine distress,and acidosis(P<0.05).Multivariate logistic regression analysis shows that birth weight<1000 g(β=1.905,95%CI:2.461-18.330),placental membrane and umbilical cord abnormalities(β=1.549,95%CI:1.784-12.414),with chorioamnionitis(β=1.825,95%CI:2.338-16.443),with intrauterine distress(β=1.347,95%CI:1.521-9.726),with acidosis(β=0.913,95%CI:1.012-6.132)were risk factors for aEEG abnormalities in extremely low and ultra-low birth weight infants(OR>1,P<0.05).Conclusion The incidence of abnormal aEEG in extremely low and ultra-low birth weight infants is relatively high,and birth weight<1000 g,abnormalities of placental membranes and umbilical cords,and chorioamnionitis are risk factors for abnormal aEEG in children,indicating that aEEG can be used to evaluate the neurological development of children in the early stage.