晚期早产儿神经发育预后及影响因素分析
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摘要
目的:对比分析晚期早产儿及正常足月儿间神经发育情况的差异,探讨影响晚期早产儿神经发育异常的相关因素。方法:以我院妇产科分娩成功的晚期早产儿134例及同期正常分娩足月儿100例为研究对象,统计他们的一般资料并进行发育商测试,采用Logistic回归分析筛选影响晚期早产儿神经发育的危险因素。结果:除适应性及社会行为两项外,晚期早产儿组的大运动、精细动作、语言评分及DQ评分均显著降低(P<0.05);晚期早产儿组出现神经发育异常者9例,发生率为6.72%,较对照组(1.00%)显著升高(P<0.05);晚期早产儿神经发育异常与极低出生体重、低血糖、母亲文化程度低密切相关。结论:晚期早产儿神经发育水平较正常足月儿显著降低,极低出生体重、低血糖、父母文化程度低是影响其神经发育的主要因素。
Objective: To compare the difference of neurological development between late preterm and full-term infants and to explore the associated impacts of late preterm infants at 1 year old and 2 year old. Methods: A total of 134 late preterm infants and 100 full-term infants delivered at our hospital received assessments of "0-6-year-old children intelligence development scale"for neurological development at 1 year old and 2 year old. Social-domestic and clinical factors related to neurological development were analyzed with Logistic regression. Results: The fine moment,strength exercises,language and DQ score of late preterm infants were significantly reduced except emotion and social behavior( P < 0. 05). Higher abnormal rate of low DQ was found among late preterm infants( 6. 72%) than normal infants( 1. 00%)( P < 0. 05). Very-low-birth-weight,hypoglycemia education level of mother were related to DQ scores of late preterm infants. Conclusion: The late preterm infants are much likely to suffer from neurological developmental delay. It is closely related to very-low-birth-weight,hypoglycemia education level of mother.
Objective: To compare the difference of neurological development between late preterm and full-term infants and to explore the associated impacts of late preterm infants at 1 year old and 2 year old. Methods: A total of 134 late preterm infants and 100 full-term infants delivered at our hospital received assessments of "0-6-year-old children intelligence development scale"for neurological development at 1 year old and 2 year old. Social-domestic and clinical factors related to neurological development were analyzed with Logistic regression. Results: The fine moment,strength exercises,language and DQ score of late preterm infants were significantly reduced except emotion and social behavior( P < 0. 05). Higher abnormal rate of low DQ was found among late preterm infants( 6. 72%) than normal infants( 1. 00%)( P < 0. 05). Very-low-birth-weight,hypoglycemia education level of mother were related to DQ scores of late preterm infants. Conclusion: The late preterm infants are much likely to suffer from neurological developmental delay. It is closely related to very-low-birth-weight,hypoglycemia education level of mother.
引文
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[14]谢红园,赵静,张戚琴.2010例新生儿听力筛查的质量控制分析[J].东南大学学报:医学版,2009,28(5):433-434.
[15]员丽,张卫星,赵宝君.328例晚期早产儿的临床分析[J].中国医药指南,2013,33:399-400.
[16]冯子鉴,毛健,陈丹,等.高危晚期早产儿脑损伤病因学及其磁共振发现[J].中国循证儿科杂志,2013,5(13):338-345.
[2]陈飒英,孙京惠,王云峰,等.不同胎龄早产儿1岁时体格和神经发育差异分析[J].中国新生儿科杂志,2011,26(3):177-180.
[3]徐萍,张雪峰,李瑛,等.晚期早产儿健康状况及其影响因素探讨[J].中华儿科杂志,2009,47(12):931-934.
[4]中华医学会儿科学分会新生儿学组.新生儿缺氧缺血性脑病诊断标准[J].中国当代儿科杂志,2005,7(2):97-98.
[5]刘秀梅,初清.晚期早产儿神经发育预后及影响因素分析[J].中国新生儿科杂志,2012,27(4):233-236.
[6]鲁利群,母得志.晚期早产儿的神经发育[J].中华实用儿科临床杂志,2014,29(2):144-146.
[7]刘畅,富建华,薛辛东,等.早产儿脑白质损伤的早期影像学改变及其对预后的影响[J].中华儿科杂志,2012,50(10):762-766.
[8]OSBOTN D A,EVANS N,KLUCKOW M,et al.Low superior vena cava flow and effect of inotropes on neurodevelopment to3 years in preterm infants[J].Pediatrics,2007,120:372-380.
[9]封志纯,李丽华,孔祥永,等.晚期早产儿的临床特点及神经发育异常的风险[J].临床儿科杂志,2011,29(2):199-200.
[10]王晨,王丹华.宫内生长受限儿的神经发育预后[J].中国新生儿科杂志,2009,24:381-383.
[11]朱雪萍,张瑞宣,孙朝琪.63例新生儿高胆红素血症的临床预后分析[J].东南大学学报:医学版,2004,23(4):262-263.
[12]武巧珍,陈洁,林德熙,等.足月新生儿出生至2岁巨细胞病毒抗体的动态变化[J].东南大学学报:医学版,2012,31(6):688-692.
[13]PETRINI J R,DIAS T,MCCORMICK M C,et al.Increased risk of adverse neurological development for late preterm infants[J].J Pediatr,2009,154:169-176.
[14]谢红园,赵静,张戚琴.2010例新生儿听力筛查的质量控制分析[J].东南大学学报:医学版,2009,28(5):433-434.
[15]员丽,张卫星,赵宝君.328例晚期早产儿的临床分析[J].中国医药指南,2013,33:399-400.
[16]冯子鉴,毛健,陈丹,等.高危晚期早产儿脑损伤病因学及其磁共振发现[J].中国循证儿科杂志,2013,5(13):338-345.