| Project/Area Number |
18K07837
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 52050:Embryonic medicine and pediatrics-related
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| Research Institution | Kanagawa Children's Medical Center (Clinical Research Institute) |
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Principal Investigator |
TOYOSHIMA Katsuaki 地方独立行政法人神奈川県立病院機構神奈川県立こども医療センター(臨床研究所), 臨床研究所, 部長 (50307542)
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| Project Period (FY) |
2018-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | 早産児 / 心エコー検査 / 低出生体重児 / 動脈管開存症 / 心臓超音波検査 / 発達遅滞 / 脳性麻痺 / 発達予後 / 動脈管 / 新生児 / 発達 |
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| Outline of Final Research Achievements |
In Japan, patent ductus arteriosus (PDA) in preterm infants have been
treated based on echocardiographic indexes. In this prospective study conducted in 31 institutes in Japan, we investigated the effects of PDA echocardiographic indices, details and timing of early PDA treatment on 3-year prognosis in 399 preterm infants born at less than 30 weeks' gestation and underwent developmental examination at 3 years of age. The incidence of combined complications including developmental delay, cerebral palsy, visual impairment, and hearing impairment was 43% at 23-24 weeks of gestation, 35% at 25-26 weeks, 23% at 27-28 weeks, and 17% at 29 weeks. PDA echocardiographic index and treatment were not clearly associated with combined complications. There was no difference in complications between those with or without surgery. Treatment of PDA in premature infants based on echocardiography can be life-saving with minimal impact on their development.
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| Academic Significance and Societal Importance of the Research Achievements |
未熟児動脈管開存症は早産児において、死亡、重症脳室内出血、慢性肺疾患、壊死性腸炎の発症に関連する重大な合併症である。日本の新生児集中治療室(NICU)では、小児循環器学を専門としていない新生児科医が心エコー検査を基に未熟児動脈管開存症への薬物療法や外科治療を判断していることが、早産児の救命率の高さと合わせて注目されている。本研究は国内31施設の世界的にも類を見ない多施設共同研究から、日本は新生児集中治療室(NICU)で働く新生児科医が心エコー検査を適時に施行し、未熟児動脈管開存症への薬物療法や外科治療を判断していることが合併症の少ない救命につながっている可能性を示唆すると考えられる。
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