To review the reported neurodevelopmental outcome of congenital diaphragmatic hernia(CDH) survivors, identify important predictors of developmental disabilities, and describe the pathophysiological mechanisms contribu...To review the reported neurodevelopmental outcome of congenital diaphragmatic hernia(CDH) survivors, identify important predictors of developmental disabilities, and describe the pathophysiological mechanisms contributing to adverse outcome. A Medline search was performed for English-language articles cross-referencing CDH with pertinent search terms. Retrospective, prospective, and longitudinal follow-up studies were examined. The reference lists of identified articles were also searched. Neurodevelopmental dysfunction has been recognized as one of most common and potentially most disabling outcome of CDH. Intelligence appears to be in the low normal to mildly delayed range. Neuromotor dysfunction is common during early childhood. Behavioral problems, hearing impairment, and quality of life related issues are frequently encountered in older children and adolescence. Disease severity correlates with the degree of neurological dysfunction. Neurodevelopmental follow-up in CDH children should become standard of care to identify those who would benefit from early intervention services and improve neurological outcomes.展开更多
目的分析孕妇尿可替宁水平与2岁儿童神经认知发育的关联,探究孕妇尿可替宁水平对儿童神经发育产生影响的敏感窗口期。方法基于武汉市的一项出生队列研究,利用贝利婴幼儿发展量表—中国城市修订版评估队列中2岁儿童的神经认知发育情况,...目的分析孕妇尿可替宁水平与2岁儿童神经认知发育的关联,探究孕妇尿可替宁水平对儿童神经发育产生影响的敏感窗口期。方法基于武汉市的一项出生队列研究,利用贝利婴幼儿发展量表—中国城市修订版评估队列中2岁儿童的神经认知发育情况,评估结果由智力发展指数(mental development index,MDI)和运动发展指数(psychomotor development index,PDI)表示,MDI评分或PDI评分<80分定义为评分异常。利用广义估计方程,分析孕早、中、晚三期尿中可替宁水平与2岁儿童神经认知发育情况的关联。结果本研究纳入989对母子对,经尿比重校正后孕早、中、晚期尿液中可替宁浓度的M(P 25,P 75)分别为3.49(2.14,6.33)、3.48(1.99,6.30)和2.61(1.45,4.80)ng/mL。调整潜在混杂因素后,孕早期尿液中可替宁水平每升高1个ln浓度,MDI评分降低1.66(95%CI:-2.97,-0.35)分。在调整混杂因素后,孕早、中期尿液中可替宁的浓度与儿童MDI评分异常的风险之间存在显著的正向关联,OR(95%CI)值分别为1.25(1.03,1.51)、1.26(1.04,1.53)。未发现孕早、中、晚期尿液可替宁浓度与儿童PDI评分或者PDI评分异常之间的关联(P>0.05)。结论孕早、中期尿可替宁水平与2岁儿童神经认知发育呈显著负相关。可替宁是尼古丁的主要代谢产物,因此孕妇在孕早、中期应该避免尼古丁暴露以降低儿童神经认知发育异常的风险。展开更多
[目的]检验贝莉婴儿发育量表-Ⅱ（Bayley Scales of Infant Development—Ⅱ，BSID-Ⅱ）的信度和效度及家长的可接受性，探讨其在我国引进和使用的可行性。[方法]对30例婴幼儿先后行BSID-U及Gesell量表的测试，并在BSID-Ⅱ测试中由2名...[目的]检验贝莉婴儿发育量表-Ⅱ（Bayley Scales of Infant Development—Ⅱ，BSID-Ⅱ）的信度和效度及家长的可接受性，探讨其在我国引进和使用的可行性。[方法]对30例婴幼儿先后行BSID-U及Gesell量表的测试，并在BSID-Ⅱ测试中由2名专业人员同时进行评分，之后对家长做有关两种量表的问卷调查。[结果]BSID-Ⅱ量表的效度较好，其中智力发育指数（mental developmenti ndex，MDI）与Gesell的应物能发育商（developmental quotience，DQ）、言语能DQ、应人能DQ及三能区总DQ之间均呈高度相关，r为0．66～0．76。神经运动发育指数（psychomotor development index，PDI）与Gesell的动作能DQ之间亦呈显著相关。量表的二人信度高，且家长对BSID-Ⅱ的总体评价高于Gesell。[结论]BSID-Ⅱ量表在我国引进和使用既是可行的，又是必要的。展开更多
文摘To review the reported neurodevelopmental outcome of congenital diaphragmatic hernia(CDH) survivors, identify important predictors of developmental disabilities, and describe the pathophysiological mechanisms contributing to adverse outcome. A Medline search was performed for English-language articles cross-referencing CDH with pertinent search terms. Retrospective, prospective, and longitudinal follow-up studies were examined. The reference lists of identified articles were also searched. Neurodevelopmental dysfunction has been recognized as one of most common and potentially most disabling outcome of CDH. Intelligence appears to be in the low normal to mildly delayed range. Neuromotor dysfunction is common during early childhood. Behavioral problems, hearing impairment, and quality of life related issues are frequently encountered in older children and adolescence. Disease severity correlates with the degree of neurological dysfunction. Neurodevelopmental follow-up in CDH children should become standard of care to identify those who would benefit from early intervention services and improve neurological outcomes.
文摘目的分析孕妇尿可替宁水平与2岁儿童神经认知发育的关联,探究孕妇尿可替宁水平对儿童神经发育产生影响的敏感窗口期。方法基于武汉市的一项出生队列研究,利用贝利婴幼儿发展量表—中国城市修订版评估队列中2岁儿童的神经认知发育情况,评估结果由智力发展指数(mental development index,MDI)和运动发展指数(psychomotor development index,PDI)表示,MDI评分或PDI评分<80分定义为评分异常。利用广义估计方程,分析孕早、中、晚三期尿中可替宁水平与2岁儿童神经认知发育情况的关联。结果本研究纳入989对母子对,经尿比重校正后孕早、中、晚期尿液中可替宁浓度的M(P 25,P 75)分别为3.49(2.14,6.33)、3.48(1.99,6.30)和2.61(1.45,4.80)ng/mL。调整潜在混杂因素后,孕早期尿液中可替宁水平每升高1个ln浓度,MDI评分降低1.66(95%CI:-2.97,-0.35)分。在调整混杂因素后,孕早、中期尿液中可替宁的浓度与儿童MDI评分异常的风险之间存在显著的正向关联,OR(95%CI)值分别为1.25(1.03,1.51)、1.26(1.04,1.53)。未发现孕早、中、晚期尿液可替宁浓度与儿童PDI评分或者PDI评分异常之间的关联(P>0.05)。结论孕早、中期尿可替宁水平与2岁儿童神经认知发育呈显著负相关。可替宁是尼古丁的主要代谢产物,因此孕妇在孕早、中期应该避免尼古丁暴露以降低儿童神经认知发育异常的风险。
文摘[目的]检验贝莉婴儿发育量表-Ⅱ（Bayley Scales of Infant Development—Ⅱ，BSID-Ⅱ）的信度和效度及家长的可接受性，探讨其在我国引进和使用的可行性。[方法]对30例婴幼儿先后行BSID-U及Gesell量表的测试，并在BSID-Ⅱ测试中由2名专业人员同时进行评分，之后对家长做有关两种量表的问卷调查。[结果]BSID-Ⅱ量表的效度较好，其中智力发育指数（mental developmenti ndex，MDI）与Gesell的应物能发育商（developmental quotience，DQ）、言语能DQ、应人能DQ及三能区总DQ之间均呈高度相关，r为0．66～0．76。神经运动发育指数（psychomotor development index，PDI）与Gesell的动作能DQ之间亦呈显著相关。量表的二人信度高，且家长对BSID-Ⅱ的总体评价高于Gesell。[结论]BSID-Ⅱ量表在我国引进和使用既是可行的，又是必要的。
