Analysis Of Related Influencing Factors For The Poor Clinical Outcomes In Premature Infant And Its Brain Resting-State Functional Magnetic Resonance Imaging Characteristics

Objective :In this study,we further investigate the clinical outcome and related risk factors of premature infants with VLBW and ELBW and the characteristics of brain resting-state functional magnetic resonance through retrospective analysis of hospitalization data of premature infants,and collection of RS-f MRI data of hospitalized infants.Providing a reference for further improve the success rate of VLBWI and ELBWI treatment and the reduction of the incidence of adverse outcomes.Methods:（1）The research of poor clinical outcomes of premature infants: extremely low/very low birth weight infant admitted to the neonatal intensive care units（NICU）of Anhui Children’s Hospital from January 2016 to December 2020 submitted the following data:the perinatal data and clinical treatment results and analyzed the major factors for poor clinical outcomes.（2）The research of RS-f MRI characteristics of premature infants: Philips Achieva 1.5t MRI system was used to collect the data of normal premature infants and term infants.DPABI5.1 was used to preprocess the image data,and then REST1.8 was used for statistical analysis to compare the ALFF values of premature infants and term infants in different.Results:（1）The research of poor clinical outcomes of premature infants: 604 infants were enrolled,including 536 cases of VLBWI and 68 cases of ELBWI,the incidence of poor clinical outcomes was 45.53%.According to the univariate analysis,the incidence of respiratory distress syndrome,pulmonary hemorrhage,neonatal asphyxia,resuscitation,PS application,and mechanical ventilation for more than 1 week et al in the poor clinical outcome group was higher than that in the cured group.However,the gestational age and birth weight were lower than those in the cured group.The incidence of anemia,blood transfusion,intravenous nutrition for more than 2 weeks,and oral probiotics was all lower than cured group,the differences in each group have statistically significant（P<0.05）.According to multivariate analysis,neonatal asphyxia（OR=1.489,P<0.05）,pulmonary hemorrhage（OR=2.037,P<0.05）,respiratory failure（OR=1.763,P<0.01）,mechanical ventilation for more than 1 week（OR=1.685,P<0.05）),pulmonary hypertension（OR=2.061,P<0.01）,and acidosis（OR=1.819,P<0.01）were independent risk factors for adverse clinical outcomesin poor clinical outcomes,while birth weight（OR=0.988,P< 0.01）and oral probiotics（OR=0.336,P<0.01）were protective factors for poor clinical outcomes（2）The research of RS-f MRI characteristics of premature infants: A total of 14full-term infants and 15 premature infants were included.ALFF value in the left parahippocampal gyrus of premature infant group was lower than that of the term group,while the ALFF value in the right precuneus,right parahippocampal gyrus and right superior marginal gyrus was higher than that in the full-term infants group,and the difference was statistically significant.Conclusion:（1）Preventing premature birth actively,reducing neonatal asphyxia and mechanical ventilation,and treating related complications in time were effective methods to improve the survival rate of ELBWI and VLBWI.（2）In the resting state,compared with full-term infants,the functional activities of premature infants in some brain regions such as the right precuneus,right parahippocampal gyrus,and right superior limbal gyrus were higher,while those in the left parahippocampal gyrus were lower in premature infants.