Objective To determine the risk on brain lesions according to gestational age (GA) in neonates with neonatal encephalopathy. Design Secondary analysis of the prospective national French population-based cohort, Long-Term Outcome of NeonataL EncePhALopathy. Setting French neonatal intensive care units. Patients Neonates with moderate or severe neonatal encephalopathy (NE) born at ≥34 weeks’ GA (wGA) between September 2015 and March 2017. Main outcome measures The results of MRI performed within the first 12 days were classified in seven injured brain regions: basal ganglia and thalami, white matter (WM), cortex, posterior limb internal capsule, corpus callosum, brainstem and cerebellum. A given infant could have several brain structures affected. Risk of brain lesion according to GA was estimated by crude and adjusted ORs (aOR). Results MRI was available for 626 (78.8%) of the 794 included infants with NE. WM lesions predominated in preterm compared with term infants. Compared with 39–40 wGA neonates, those born at 34–35 wGA and 37–38 wGA had greater risk of WM lesions after adjusting for perinatal factors (aOR 4.0, 95% CI (1.5 to 10.7) and ORa 2.0, 95% CI (1.1 to 3.5), respectively). Conclusion WM is the main brain structure affected in late-preterm and early-term infants with NE, with fewer WM lesions as GA increases. This finding could help clinicians to estimate prognosis and improve the understanding of the pathophysiology of NE. Trial registration number [NCT02676063][1], ClinicalTrials.gov. Data may be obtained from a third party and are not publicly available. De-identified participant data are available on request from tdebillon@chu-grenoble.fr, principal investigator. The latter will make the request to the research laboratory hosting the database. (MESP Laboratory, TIMC Grenoble University Hospital). Reuse conditions may be authorised subject to strict analysis conditions and a specific purpose. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02676063&atom=%2Ffetalneonatal%2Fearly%2F2024%2F02%2F28%2Farchdischild-2023-326131.atom

中文翻译：

---

胎龄对新生儿脑病脑部病变的影响

目的 根据胎龄（GA）判断新生儿脑病新生儿脑部病变的风险。设计对法国全国人群前瞻性队列的二次分析，新生儿脑病的长期结果。设置法国新生儿重症监护病房。患者 2015 年 9 月至 2017 年 3 月期间出生的 GA (wGA) ≥ 34 周的患有中度或重度新生儿脑病 (NE) 的新生儿。 主要结局指标 前 12 天内进行的 MRI 结果分为七个受伤脑区：基底脑区神经节和丘脑、白质（WM）、皮质、后肢内囊、胼胝体、脑干和小脑。特定婴儿的多个大脑结构可能会受到影响。根据 GA，通过粗略和调整后的 OR (aOR) 来估计脑损伤的风险。结果 794 名 NE 婴儿中，有 626 名（78.8%）可以获得 MRI。与足月婴儿相比，WM 病变在早产儿中占主导地位。与 39-40 wGA 新生儿相比，调整围产期因素后，34-35 wGA 和 37-38 wGA 出生的新生儿发生 WM 病变的风险更大（aOR 4.0，95% CI（1.5 至 10.7）和 ORa 2.0，95% CI （分别为 1.1 至 3.5））。结论 WM 是晚期早产儿 NE 受影响的主要脑结构，随着 GA 的增加，WM 病变逐渐减少。这一发现可以帮助临床医生评估预后并提高对 NE 病理生理学的理解。试验注册号 [NCT02676063][1]，ClinicalTrials.gov。数据可能从第三方获得，并且不公开。可向首席研究员 tdebillon@chu-grenoble.fr 索取去识别化的参与者数据。后者将向托管数据库的研究实验室提出请求。（MESP 实验室，TIMC 格勒诺布尔大学医院）。可以根据严格的分析条件和特定目的授权重用条件。[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02676063&atom=%2Ffetalneonatal%2Fearly%2F2024%2F02%2F28%2Farchdischild-2023-326131.atom