Threatened preterm labor is a risk factor for impaired cognitive development in early childhood

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• 作者：Cristina Paules ; MD^a ; Victoria Pueyo ; MD ; PhD^b ; ^{vpueyo@unizar.es} ; Elena Martí ; ^c ; Susana de Vilchez^c ; Irina Burd ; MD ; PhD^d ; Pilar Calvo ; MD^a ; Daniel Oros ; MD ; PhD^a
• 关键词：neurodevelopment ; preterm birth ; threatened preterm labor
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：216
• 期：2
• 页码：157.e1-157.e7
• 全文大小：555 K
• 卷排序：216

文摘

Threatened preterm labor is a leading cause of hospital admission during pregnancy. Patients with an episode of threatened preterm labor who deliver at term are considered to have false preterm labor. However, threatened preterm labor has been proposed as a pathologic insult that is not always sufficient to induce irreversible spontaneous preterm birth but that could alter the normal course of pregnancy.ObjectiveThe aim of this study was to evaluate threatened preterm labor during pregnancy as a risk factor of neurodevelopmental deficits of children at 2 years of age.Study DesignTwo-year-old children who were born late preterm (n=22) or at term after threatened preterm labor (n=23) were compared with at-term control children (n=42). Neurodevelopment was evaluated at a corrected age of 24–29 months with the use of the Merrill-Palmer-Revised Scales of Development.ResultsChildren who were born at term after threatened preterm labor had lower scores than control children on global cognitive index (95.4 vs 104.2; P=.011), cognition (95.1 vs 103.1; P=.021), fine motor (95.2 vs 103.4; P=.003), gross motor (84.7 vs 99.8; P=.001), memory (92.9 vs 100.4; P=.015), receptive language (93.9 vs 102.9; P=.03), speed of processing (105.7 vs 113.3; P=.011), and visual motor coordination (98.8 vs 106.7; P=.003) subtests. Children born at term after threatened preterm labor had an increased risk of mild neurodevelopmental delay compared with control children (odds ratio for global cognitive index, 2.06; 95% confidence interval, 1.09–3.88; P=.033). There were no significant differences in any cognitive domain between children who were born late preterm and children who were born at term after threatened preterm labor.ConclusionsThreatened preterm labor is a risk factor for impaired cognitive development at 2 years of age, even if birth occurred at term.