Journal of Developmental Medicine(Electronic Version)  2024, Vol. 12 Issue (4): 263-270 DOI: 10.3969/j.issn.2095-5340.2024.04.004 |
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| Effect of fetal distress on cerebral blood flow perfusion of very preterm infants observed by using arterial spin labeling imaging technique |
| Xue Qianru, Qin Fanyue, Zhang Chen, et al
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(Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China)
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Abstract 【Abstract】 Objective To evaluate the effect of cerebral blood flow perfusion in very preterm infants withfetal distress by arterial spin labeling (ASL) imaging technique. Method Using a prospective cohort studymethod, a total of 53 very preterm infants who were born and hospitalized in the Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University from August 2021 to April 2023 were selected as theresearch objects. According to the presence or absence of fetal distress, they were divided into distress group(n=22) and non-distress group (n=31). The differences in cerebral blood flow in different regions of interestof brain tissue between the two groups were analyzed. The correlation between fetal distress and cerebralblood flow changes was analyzed by multiple linear regression analysis. Independent sample t-test orcorrection t-test, Mann-Whitney U test and χ2 test or Fisher exact probability methodwere used forstatistical analysis. Result The proportion of singletons was significantly higher in the distress groupthan in the non-distress group [81.8% (18/22) vs 54.8% (17/31), χ2=4.176, P<0.05]. In the very preterminfants, the cerebral blood flow (CBF) in the bilateral frontal lobes [left: 23.9 (21.7, 28.0) ml/(100 g·min) vs21.5 (18.2, 23.8) ml/(100 g·min), t=-2.826; right: (24.5±0.9) ml/(100 g·min) vs (21.2±0.8) ml/(100 g·min),t=2.773], bilateral temporal lobes [left: (22.8±0.9) ml/(100 g·min) vs (19.8±0.6) ml/(100 g·min),t=2.834; right: (23.2±0.9) ml/(100 g·min) vs (20.8±0.7) ml/(100 g·min), t=2.108], bilateral parietallobes [left: (24.0±1.1) ml/(100 g·min) vs (19.4±0.8) ml/(100 g·min), t=3.377; right: 25.6 (18.9, 28.1) ml/(100 g·min) vs 19.6 (16.3, 22.5) ml/(100 g·min), t=-2.311], bilateral occipital lobes [left: (25.7±1.4) ml/(100 g·min) vs (21.2±0.9) ml/(100 g·min), t=2.796; right: (26.3±1.6) ml/(100 g·min) vs (21.7±1.0) ml/(100 g·min), t=2.583], bilateral basal ganglia [left: (35.4±1.5) ml/(100 g·min) vs (29.0±0.8) ml/(100 g·min),t'=3.872; right: (34.9±1.4) ml/(100 g·min) vs (29.3±1.0) ml/(100 g·min), t=3.457], and bilateral thalami[left: (40.0±2.0) ml/(100 g·min) vs (35.0±1.3) ml/(100 g·min), t=2.157; right: (40.5±1.7) ml/(100 g·min)vs (35.1±1.1) ml/(100 g·min), t=2.783] were significantly higher in the distress group than in the non-distressgroup (all P<0.05). After adjusting for confounders using a multiple linear regression model (singleton, birthweight, gestational age at birth, corrected gestational age at the time of ASL, gender, most recent hematocritat the time of ASL, duration of assisted ventilation, placenta previa, placental abruption, umbilical cordabnormality, meconium-stained amniotic fluid, hypertensive disorders of pregnancy and diabetes, and acutechorioamnionitis), fetal distress was still associated with CBF in the bilateral temporal lobes (left: 95% CI:0.208~4.941, right: 95% CI: 0.047-4.636), left frontal lobe (95% CI: 0.047-4.636), and bilateral basal ganglia(left: 95% CI: 2.230-8.983, right: 95% CI: 1.503-8.912) (all P< 0.05). Conclusion The CBF values ofeach region of interest in the brain after birth are quantitatively measured by ASL imaging technology, and itis found that fetal distress can increase theblood flow perfusion of bilateral temporal cortex left parietal lobeand bilateral basal ganglia in very preterminfants, which may lead to an increased risk of brain injury in verypreterm infants.
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Received: 31 October 2023
Published: 31 July 2024
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