International Journal of Reproductive BioMedicine
International Journal of Reproductive BioMedicine
IJRM
Medical Sciences
http://ijrm.ir
1
admin
2476-4108
2476-3772
10.29252/ijrm
en
jalali
1402
11
1
gregorian
2024
2
1
22
2
online
1
fulltext
en
تجزیه و تحلیل وجود شریان نافی منفرد با ناهنجاری مادرزادی همزمان: آیا این یک عامل خطر برای پیشآگهی ضعیف است؟ یک مطالعه مقطعی
Analysis of single umbilical artery with concurrent congenital anomaly: Is it a risk factor for poor prognosis? A cross-sectional study
Perinatology
Original Article
Original Article
<div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">یک شریان نافی منفرد (</span></span><span dir="LTR" style="font-size:10.0pt">SUA</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) ممکن است با یک ناهنجاری منفرد یا چندین ناهنجاری مادرزادی همراه باشد. اگرچه ناهنجاری­های مرتبط با </span></span><span dir="LTR" style="font-size:10.0pt">SUA</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">به صورت اولیه می</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">توانند باعث مرگ و میر پری</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">ناتال بالا شوند، اما اهمیت بالینی آنها ارزیابی نشده است.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">ما رابطه بین ویژگی­های بالینی و نوع یا تعداد ناهنجاری­های همزمان در نوزادان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">SUA</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">را بررسی کردیم.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مواد و روش­ ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">در این مطالعه مقطعی، 104 نوزاد مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">SUA</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">از ژانویه 2000 تا دسامبر 2020 در بیمارستان </span></span><span dir="LTR" style="font-size:10.0pt">Dongsan</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">، </span></span><span dir="LTR" style="font-size:10.0pt">Daegu</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">، کره جنوبی وارد مطالعه شدند. اطلاعات مربوط به شرح حال مادر در حامگی و مشخصات دموگرافیک نوزاد، سیر بالینی، تجزیه و تحلیل کروموزومی و ناهنجاری­های مادرزادی جمع­آوری شد.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">از میان نوزادان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">SUA</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">، 77 نفر (0/%74) یک یا چند ناهنجاری مادرزادی داشتند. ناهنجاری­ها در 66 نفر (5/%63) قلبی، 20 نفر (2/%19) تناسلی، 12 نفر (5/%11) در دستگاه گوارش، 5 نفر (8/%4) در سیستم عصبی مرکزی، 12 نفر (5/%11) اسکلتی و 5 نفر (8/%4) آنومالی­های صورت بودند. تعداد ناهنجاری­های همزمان از 0 تا 4 متغیر بود. نوزادان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">SUA</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">و ناهنجاری</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">های گوارشی همزمان، شیوع بالایی از تهویه مثبت اولیه، لوله­گذاری و مصرف داروی اینوتروپیک و نمره آپگار پایین­تر در دقیقه 1 و 5 را داشتند. 7 (7/%6) نوزاد مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">SUA</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">فوت کردند. وزن کم هنگام تولد (نسبت شانس = 16/6، 05/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">)، چند فرزندی مادر (41/2، 13/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">)، ناهنجاری گوارشی (06/5، 11/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) و احیای اولیه قلبی (77/7، 11/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) عوامل خطر مرگ و میر در نوزادان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">SUA</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">بودند.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نتیجه ­گیری: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نوزادان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">SUA</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">و ناهنجاریهای گوارشی همزمان، وزن کم هنگام تولد، چند فرزندی مادر و احیای اولیه قلبی پیامدهای ضعیفی داشتند.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br>
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<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Mitra"">کلمات کلیدی: </span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Mitra"">شریان نافی منفرد، ناهنجاری­های مادرزادی، پری ناتال مورتالیتی.</span></span></i></span></span></span></span></span></div>
<p style="text-align: justify;"><span style="font-family:Times New Roman;"><span style="font-size:10pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Background:</span></b><span style="font-size:12.0pt"> A single umbilical artery (SUA) may coexist with a single anomaly or multiple congenital anomalies. Although anomalies associated with SUA can primarily cause high perinatal mortality, their clinical significance has not been evaluated.</span></span></span><br>
<span style="font-size:10pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Objective:</span></b><span style="font-size:12.0pt"> We investigated the relationship between the clinical features and <a name="_Hlk136163897">the type or number of concurrent anomalies</a> <a name="_Hlk136163929">in neonates with SUA</a>.</span></span></span><br>
<span style="font-size:10pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Materials and Methods:</span></b><span style="font-size:12.0pt"> In this cross-sectional study, 104 neonates with SUA were enrolled from January 2000 to December 2020 at Dongsan hospital, Daegu, South Korea. Data on the maternal history and the neonates demographic characteristics, clinical course, chromosomal analysis, and congenital anomalies, were collected. </span></span></span><br>
<span style="font-size:10pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Results:</span></b><span style="font-size:12.0pt"> Among the neonates with SUA included, 77 (74.0%) had one or more congenital anomalies; 66 (63.5%) were cardiac, 20 (19.2%) were genitourinary, 12 (11.5%) were gastrointestinal, 5 (4.8%) were central nervous system, 12 (11.5%) were skeletal, and 5 (4.8%) were facial anomalies. The number of concurrent anomalies ranged from 0-4. Neonates with SUA and concurrent gastrointestinal anomaly had a high incidence of initial positive ventilation, intubation, and inotropic drug use and lower Apgar score at 1 min and 5 min. 7 (6.7%) neonates with SUA died. Low birth weight (odds ratio = 6.16, p = 0.05), maternal multiparity (2.41, p = 0.13), gastrointestinal anomaly (5.06, p = 0.11), and initial cardiac resuscitation (7.77, p = 0.11) were </span><span style="font-size:12.0pt">risk factors for mortality in neonates with SUA.</span></span></span><br>
<span style="font-size:10pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Conclusion:</span></b><span style="font-size:12.0pt"> Neonates with SUA and concurrent gastrointestinal anomaly, low birth weight, maternal multiparity, and initial cardiac resuscitation had poor outcomes.</span></span></span><br>
<span style="font-size:10pt"><span style="line-height:normal"><span style="font-family:"Times New Roman","serif""></span></span></span></span></p>
شریان نافی منفرد, ناهنجاریهای مادرزادی, پری ناتال مورتالیتی.
Single umbilical artery, Congenital abnormalities, Perinatal mortality.
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148
http://ijrm.ir/browse.php?a_code=A-10-2315-1&slc_lang=en&sid=1
Na Hyun
Lee
us22382@naver.com