母亲妊娠期高血压疾病对新生儿脑发育的影响

目的　探讨母亲妊娠期高血压疾病对新生儿脑发育的影响. 方法　采用颅脑超声测量56例妊娠期高血压疾病母亲的新生儿脑岛面积、周长及新生儿脑回宽度,并与53例同胎龄对照组新生儿相比较. 结果 对照组足月儿脑回宽度低于早产儿,脑岛面积与周长大于早产儿,差异有统计学意义(P<0.01).妊娠期高血压疾病组胎龄34周以上新生儿脑岛周长[胎龄≥37周:(87.43±10.21)mm;胎龄34～37周:(72.59±7.50)mm]与面积[胎龄≥37周:(413.60±90.05)mm2;胎龄34～37周:(285.71±48.62)mm2]明显小于对照组同胎龄新生儿脑岛周长[胎龄≥37周:(102.14±9.97)mm;胎龄34～37周:(78.42±10.14)mm]和面积[胎龄≥37周:(557.08±98.89)mm2;胎龄34～37周:(356.01±93.07)mm2],差异有统计学意义(P<0.05或0.01).妊娠期高血压疾病组小于胎龄儿发生率为30.36%(17/56),其脑回宽度宽于适于胎龄儿,脑岛面积与周长明显减小,差异均有统计学意义.妊娠期高血压疾病组新生儿均有肌张力增高,在新生儿行为神经测定评分时,主动、被动肌张力共8项都未扣分,但行为能力扣分较多,分值明显低于对照组(P<0.01). 结论 母亲妊娠期高血压疾病可造成新生儿脑发育欠佳,可通过颅脑超声测量新生儿脑岛面积、周长及脑回宽度予以评价.

Effect of maternal hypertensive disorders complicating pregnancy on brain development of the neonates

Objective To study the effect of maternal hypertensive disorders complicating pregnancy on brain development of the neonates. Methods Insular area,circle and cerebral gyri width of lobus frontals were measured in 56 neonates of the mothers with hypertensive disorder complicating pregnancy(HDCP)by ultrasound and were compared with those of 53 neonates of the mothers without HDCP(control group). Results In the control group,the cerebral gyri width of term neonates was narrower than that of preterm neonates,while the insular circle was longer and the insular area was larger in the term neonates(P<0.01).Insular circle was significantly shorter and the insular area was significantly smaller in neonates of HDCP mothers [term:(87.43±10.21)mm,(413.60±90.05)mm2;preterm:(72.59±7.50)mm,(285.71±48.62)mm2]than those of the corresponding neonates in the control group[term:(102.14±9.97)mm,(557.08±98.89)mm2:preterm:(78.42±10.14)mm,(356.01±93.07)mm2].Cerebral gyri width were significantly wider only in the full term neonates.The incidence of small gestational age neonates was 30.36%(17/56)in hypertensive disorder complicating pregnancy group.The neonatal behavioral neurological score of hypertensive disorder complicating pregnancy group was significantly lower than that of control group (P<0.01). Conclusions Maternal hypertensive disorder complicating pregnancy may result in poor development of brain of their neonates,which could be evaluated by cerebral ultrasound.