JAMA子刊:胼胝体发育与胎儿生长受限及母体先兆子痫或妊娠高血压之间的关系

2022-08-17 liangying MedSci原创

在PE或GH妊娠的FGR胎儿中,CC(主要是脾区)的结构发育下降可能与不良围产期结局的高风险显著相关。

先兆子痫(PE)或妊娠高血压(GH)是一种常见的医学疾病,与一系列母婴并发症相关,包括肾功能不全、肝损伤、肺水肿、子痫、胎儿生长受限(FGR)和死产。流行病学研究的证据表明,PE或GH影响全球2%至10%的妊娠,并与后代的某些神经发育障碍有关,尤其是FGR。

本研究评估了“有PE/GH伴FGR的孕妇”,“有PE/GH无FGR的孕妇”和“血压正常的孕妇”之间胎儿胼胝体(CC)发育是否存在差异,特别是判断CC发育是否与母亲疾病和FGR的严重程度相关,并确定不良围产期结局与有FGR的胎儿CC结构发育之间的关联。

这项回顾性匹配病例对照研究于2014年1月1日至2021年1月31日在中国杭州浙江大学医学院附属妇女医院进行。被试组包括单胎妊娠合并PE或GH合并FGR组,对照组包括未发生FGR的PG或GH组和正常妊娠组。在磁共振成像(MRI)上测量并分析胎儿CC的长度、厚度、总面积、细分面积和表观扩散系数(ADC)值。进一步研究了不良围产期结局与CC结构发育之间的关系。

共有56名单胎妊娠和PE或GH的孕妇以及FGR胎儿入选。结果发现,与无FGR和正常血压妊娠的病例相比,有FGR的PE或GH病例的胎儿CC长度中位数(IQR)和平均(SD)CC总面积(根据头指数进行调整)明显减少。在所有组中,胎儿CC的脾区在宏观结构发育和微观结构发育方面也表现出明显的改变。此外,在PE或GH伴FGR组中,脾区结构异常与不良围产儿结局之间存在显著相关性。

子痫前期或妊娠高血压合并FGR的胎儿CC的宏观结构变化与围产期结局的关系

本研究的结果表明,在PE或GH妊娠的FGR胎儿中,CC(主要是脾区)的结构发育下降可能与不良围产期结局的高风险显著相关,并可能被视为一种基于MRI的生物标志物,用于更好的产前咨询和早期管理决策。

参考文献:Zheng W, Zhang X, Feng Y, et al. Association of Corpus Callosum Development With Fetal Growth Restriction and Maternal Preeclampsia or Gestational Hypertension. JAMA Netw Open. 2022;5(8):e2226696. doi:10.1001/jamanetworkopen.2022.26696

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    2022-08-18 neurowu
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    2022-08-16 肿瘤克星

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