The study of pathophysiology and prediction of umbilical cord ulcer by a registry of fetuses with duodenal and jejunal atresia

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K16944
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52050:Embryonic medicine and pediatrics-related
• Research Institution: National Center for Child Health and Development
• Principal Investigator: Ozawa Katsusuke 国立研究開発法人国立成育医療研究センター, 周産期・母性診療センター, 部長 (70408516)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 臍帯潰瘍 / 先天性十二指腸閉鎖症 / 先天性空腸閉鎖症 / 羊水中胆汁酸濃度

Outline of Final Research Achievements

Congenital duodenal atresia and jejunal atresia can cause umbilical cord ulceration during the fetal period, leading to poor prognosis in more than half of the cases. However, the incidence and risk factors of umbilical cord ulceration have not yet been understood. This study is a prospective registry study that enrolls cases diagnosed with congenital duodenal atresia and jejunal atresia in the fetus. Umbilical cord ulcers were classified by their severity into grades 0 to 4 based on microscopic findings. Additionally, measurements such as bile acid concentration in the amniotic fluid were taken, and the association between umbilical cord ulcers and pregnancy background and fetal characteristics was investigated. A total of 23 institutions nationwide participated in the study, which began enrollment in November 2020. Enrollment is now complete, with a total of 121 cases registered, achieving the target sample size.

Free Research Field

胎児診断・胎児治療

Academic Significance and Societal Importance of the Research Achievements

現在症例登録は終了し、データを収集中である。病理診断は89例で完了したが、周産期死亡は9例あり、胎児死亡が4例、新生児死亡が5例であった。21トリソミーは28例に認められた。初回採取時の羊水中総胆汁酸濃度の中央値は9.88（Q1 2.19, Q3 19.53）μmol/Lであり、すべてデータの収集が完了してから解析に移る予定である。本研究の結果は論文として発表し、先天性十二指腸閉鎖・空腸閉鎖症を伴った児の臍帯潰瘍による予後の悪化を防ぐために有用な情報となり、予後改善のために我々が次に実施するべきことを明らかにする。