Risk Factors Of Term And Late Preterm Neonates With Cerebral Infarction Based On Propensity Score Matching

Objective: To explore the risk factors of cerebral infarction in term and late preterm neonates by propensity score matching(PSM).Methods: Term and late preterm neonates with cerebral infarction by imaging examination were selected as the case group,who were hospitalized in the Department of Neonatology,Shengjing Hospital of China Medical University from January 2015 to May 2022 without severe craniocerebral injury and inborn error of metabolism.During the same period,late preterm and term infants who had the same birth date and completely normal head imaging without neurological disease were selected as the control group.The general information and clinical data of the two groups were collected.First,univariate analysis was performed on the case group and the control group,and then PSM was used to match the two groups.Maternal age,birth weight,and gestational age were used as covariates,and the 1:2 proximity matching method was used to match the case group and the control group.After matching,univariate analysis and multivariate Logistic regression analysis were performed again to explore the risk factors of cerebral infarction in late preterm and term infants.Results: Before matching,univariate analysis showed that there were significant differences between the two groups in birth weight,gestational age,preeclampsia or eclampsia,gestational diabetes mellitus,amniotic fluid contamination grade II or above,neonatal disseminated intravascular coagulation(DIC)score ≥4 points,sepsis,exchange transfusion,and hypocalcemia after birth(p<0.05).Among them,the proportion of amniotic fluid contamination grade II or above,DIC score ≥4 points,sepsis,exchange transfusion,and hypocalcemia after birth in the cerebral infarction group was higher than that in the control group.However,the proportion of preeclampsia or eclampsia and gestational diabetes mellitus were higher in the control group.In the univariate analysis after matching,gestational diabetes mellitus,amniotic fluid contamination grade II or above,DIC score ≥4 points,and sepsis after birth were statistically significant between the two groups(P < 0.05).Multivariate Logistic regression analysis showed that amniotic fluid contamination grade II or above(OR=10.221,95%CI: 1.117,93.520),DIC score ≥4points after birth(OR=13.601,95%CI: 1.509,122.628),neonatal sepsis(OR=3.503,95%CI:1.149,10.679)were independent risk factors of cerebral infarction in late preterm and term infants.Conclusion: Amniotic fluid contamination groud II or above,neonatal sepsis and abnormal coagulation function(DIC score ≥4 points)can increase the risk of cerebral infarction in late preterm and term infants.For neonates with severe amniotic fluid contamination,sepsis and abnormal coagulation function after birth,cerebral infarction should be considered.Early neuroimaging examination should be performed to identify and intervene as soon as possible to improve the prognosis.