中国循证儿科杂志2017，Vol.12Issue(6)：423-428,6.DOI:10.3969/j.issn.1673-5501.2017.06.004
极早产儿和/或极低出生体重儿对青少年时脑体积影响的Meta分析
Effect of very preterm birth and/or very low birth weight on brain volume during adolescence:a meta-analysis
摘要
Abstract
Objective To evaluate the effects of very preterm birth ( born≤32 weeks of gestation ) and/or very low birth-weight ( VLBW, birth weight ≤ 1500 g ) on brain volume development during adolescence of 13 to 18 years old. Methods Databases including PubMed, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Database ( CBM) , WanFang Data and CNKI from inception to October 20, 2017 were searched for studies that reported volumetric outcomes in adolescents using magnetic resonance imaging, including cohort studies in which experimental groups were born with gestational age ≤32 weeks and / or birth weight≤1500 g, control group with gestational age of 38 to 42 weeks and birth weight≥2500 g, and excluding studies with congenital malformations or diseases at birth, presence of disease that may affect measurement outcome during follow-up, and studies failure to extract the measurements herein. The outcome indicators were whole brain, white matter and gray matter, cerebellum, hippocampal and corpus callosum volume. The quality of the literature was evaluated with Newcastle-Ottawa scale ( NOS) and meta-analysis was conducted with R 3.4.0 software, and the heterogeneity among the studies was assessed by I2 test. ResuIts Thirteen English studies ( n=1272) entered the meta-analysis, including 686 cases in the experimental group and 586 cases in the control group. None of the 13 studies was followed completely. In 9 studies non-exposed and exposed groups were not from the same community. 3 studies were only based on retrospective questionnaire. All of the 13 studies used MRI with field strength of 1.5T, computer software to measure the volume automatically, and the same endpoint age for both cohorts. Meta-analysis showed that compared with the control group, the whole brain volume (SMD=-0.66, 95％CI: -0.81--0.51), white matter volume (SMD=-0.51, 95％CI: -0.64--0.38), gray matter volume (SMD=-0.60, 95％CI: -0.93--0.28), Cerebellum volume ( SMD=-0.45, 95％CI:-0.64--0.25) , hippocampus volume ( SMD=-0.48, 95％CI:-0.73--0.24) and corpus callosum volume ( SMD=-0.43, 95％CI:-0.63--0.24) in the experimental group were significantly reduced, respectively. Meta-analysis of whole-brain and white matter volume using funnel plot tests did not find publication bias.ConcIusion Very preterm birth and very low birth weight have a significant negative effect on volumes of whole brain and specific region of brain in adolescents.关键词
极早产/极低出生体重/脑体积/MRI/Meta分析Key words
Very preterm/Very low birth weight/Brain volume/Magnetic resonance imaging/Meta-analysis引用本文复制引用
吴成君,曹一翀,马雪霞,杨印祥,栾佐..极早产儿和/或极低出生体重儿对青少年时脑体积影响的Meta分析[J].中国循证儿科杂志,2017,12(6):423-428,6.基金项目
国家重点研发计划基金项目:2017YFA0104200 （）
上海市第四轮公共卫生三年行动计划项目:2015-82 （）
