Objectives

To compare the term equivalent brain magnetic resonance imaging (MRI) findings between erythropoietin (Epo) treated and placebo control groups in infants 24^0/7-27^6/7 weeks of gestational age and to assess the associations between MRI findings and neurodevelopmental outcomes at 2 years corrected age.

Study design

The association between brain abnormality scores and Bayley Scales of Infant Development, Third Edition at 2 years corrected age was explored in a subset of infants enrolled in the Preterm Erythropoietin Neuroprotection Trial. Potential risk factors for neurodevelopmental outcomes such as treatment assignment, recruitment site, gestational age, inpatient complications, and treatments were examined using generalized estimating equation models.

Results

One hundred ten infants were assigned to Epo and 110 to placebo groups. 27% of MRI scans were rated as normal, and 60%, 10%, and 2% were rated as having mild, moderate, or severe abnormality. Brain abnormality scores did not significantly differ between the treatment groups. Factors that increased the risk of higher brain injury scores included intubation; bronchopulmonary dysplasia; retinopathy of prematurity; opioid, benzodiazepine, or antibiotic treatment >7 days; and periventricular leukomalacia or severe intraventricular hemorrhage diagnosed on cranial ultrasound. Increased global brain abnormality and white matter injury scores at term equivalent were associated with reductions in cognitive, motor, and language abilities at 2 years of corrected age.

Conclusions

Evidence of brain injury on brain MRIs obtained at term equivalent correlated with adverse neurodevelopmental outcomes as assessed by the Bayley Scales of Infant and Toddler Development, Third Edition at 2 years corrected age. Early Epo treatment had no effect on the MRI brain injury scores compared with the placebo group.

中文翻译：

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足月等效脑磁共振成像与极早产儿 2 年结果之间的关联：来自早产促红细胞生成素神经保护试验队列的报告

目标

^{比较孕龄 24 0/7} -27 ^6/7周婴儿的促红细胞生成素 (Epo) 治疗组和安慰剂对照组之间的术语等效脑磁共振成像 (MRI) 结果， 并评估 MRI 结果与神经发育结果之间的关联校正年龄 2 岁。

学习规划

在参加早产促红细胞生成素神经保护试验的一部分婴儿中，探讨了大脑异常评分与 Bayley 婴儿发育量表第三版在 2 岁校正年龄之间的关联。使用广义估计方程模型检查神经发育结果的潜在风险因素，如治疗分配、招募地点、胎龄、住院并发症和治疗。

结果

110 名婴儿被分配到 Epo，110 名婴儿被分配到安慰剂组。27% 的 MRI 扫描被评为正常，60%、10% 和 2% 被评为轻度、中度或重度异常。大脑异常评分在治疗组之间没有显着差异。增加较高脑损伤评分风险的因素包括插管；支气管肺发育不良; 早产儿视网膜病变; 阿片类药物、苯二氮卓类药物或抗生素治疗 >7 天；颅脑超声诊断脑室周围白质软化或严重脑室内出血。足月时大脑异常和白质损伤评分的增加与矫正年龄 2 岁时认知、运动和语言能力的下降有关。

结论

根据 Bayley 婴儿和幼儿发育量表第三版在 2 岁校正年龄评估的结果，在足月等效脑 MRI 上获得的脑损伤证据与不良神经发育结果相关。与安慰剂组相比，早期 Epo 治疗对 MRI 脑损伤评分没有影响。