GDM孕妇新生儿NBNA评分、颅脑超声指标评估早期脑发育价值  

Values of the neonatal neurobehavioral assay score and cranial ultrasound indexes of pregnant women with gestational diabetes mellitus for evaluating their neonatal early brain development

作　　者：熊翠莲 贾舒雯 胡万建 鲍杉杉 孙红燕 XIONG Cuilian;JIA Shuwen;HU Wanjian;BAO Shanshan;SUN Hongyan(Linping District Maternal and Child Health Care Hospital,Hangzhou,Zhejiang Province,311100;Children's Hospital,Hangzhou)

机构地区：[1]浙江省杭州市临平区妇幼保健院,311100 [2]浙江省杭州市儿童医院

出　　处：《中国计划生育学杂志》2023年第10期2452-2456,共5页Chinese Journal of Family Planning

摘　　要：目的:新生儿神经行为测定(NBNA)及颅脑超声对妊娠期糖尿病(GDM)孕妇新生儿脑发育情况的评估价值。方法:回顾性收集2021年1月-2022年6月在本院分娩的GDM产妇92例(GDM组)、正常分娩未合并妊娠期疾病的90例产妇(对照组)临床资料,对两组新生儿出生后2周内行NBNA测定和颅脑超声检验,观察各组新生儿NBNA异常例数;Spearman相关系数分析NBNA异常与颅脑超声指标关系;受试者工作特征曲线(ROC)分析NBNA联合颅脑超声对新生儿脑发育异常诊断价值。结果:GDM组新生儿NBNA评分低于对照组、NBNA异常比例(18.5%)高于对照组(6.7%);新生儿小脑蚓部矢状长度、胰岛周长、额叶厚度及大脑横径均低于对照组,额上回宽度高于对照组,超声异常比例(20.7%)高于对照组(5.6%)(均P<0.05)。Spearman显示,小脑蚓部矢状长度、胰岛周长、额叶厚度及大脑横径均与NBNA呈正相关,额上回宽度与NBNA呈负相关(P<0.05);NBNA联合颅脑超声诊断新生儿脑发育异常曲线下面积(0.988)高于各单一指标诊断(0.718、0.813),其敏感度为100.0%、特异度97.6%。结论:GDM孕妇新生儿脑发育异常比例升高,NBNA测评与颅脑超声指标联合应用,对早期评估新生儿脑发育异常有重要临床参考价值。Objective:To study the values of the neonatal neurobehavioral assay(NBNA)score and cranial ultrasoundindexes of pregnant women with gestational diabetes mellitus(GDM)for evaluating their neonatal early brain development.Methods:The clinical data of 92 pregnant women with GDM(in study group)and 90 normal pregnant women(in control group)who all had delivered in hospital from January 2021 to June 2022 were collected retrospectively.TheNBNA measurement and the cranial ultrasound examinations of the neonates in the two groups were performed within2 weeks after birth.The number of neonates with abnormal NBNA in the two groups was observed.Spearman correla-tion coefficient analysis was used to analyze the correlation between the abnormal NBNA of the neonates and their cra-nial ultrasonic indexes.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of NB-NA combined with craniocerebral ultrasonography for the neonatal brain developmental abnormalities.Results:TheNBNA score of the neonates in the study group was significantly lower than that of the neonates in the control group,and the rate of abnormal NBNA(18.5%)of the neonates in the study group was significantly higher than that(6.7%)of the neonates in the control group.The sagittal length of vermis cerebelli,the islet circumference,the frontal lobethickness,and the transverse diameter of the cerebrum of the neonates in the study group were significantly lower thanthose of the neonates in the control group,and the width of the superior frontal gyrus of the neonates in the study group was significantly lower higher,and the abnormal proportion of which by ultrasound(20.7%)of the neonates inthe study group was significantly higher than that(5.6%)of the neonates in the control group(all P<0.05).Spearman analysis showed that the sagittal length of cerebellar vermis,the islet circumference,the frontal lobe thickness,and the brain transverse diameter of the neonates were positively correlated with their NBNA score,while thewidth of superior fro

关 键 词：妊娠期糖尿病 新生儿 脑发育 颅脑超声指标 神经行为测定 早期评估 

分 类 号：R714.256[医药卫生—妇产科学]