Influencing factors of the neurodevelopment of high-risk infants
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摘要
Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment.
Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment.
Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment.
引文
1. Chen R, Zhao Z, Liu X. Children's Health(Fifth Edition)M. Jiangsu:Phoenix Science and Technology Press of Jiangsu, 2017.
2. Vohr B. Long-term outcomes of moderately preterm, late preterm,and early term infants. Clin Perinatol 2013;40:739-51.
3. Spittle A, Orton J, Anderson PJ, et al. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants. Cochrane Database Syst Rev 2015;(11):CD005495.
4. Tian Y, Zhang Y, Chen F, et al. The effect of multidisciplinary management system of preterm infants on the neurodevelopmental outcomes of preterm infants discharged from neonatal intensive care unit[J]. Chinese Journal of Child Health Care 2018;26:294-7.
5. Xu S, Huang H, Zhang J. The progress of research and application of diagnostic developmental evaluation scale for infants[J]. Chinese Journal of Child Health Care 2010;11:859-61.
6. Yang Y. Children's Developmental Rating Scale M. 1. Beijing:People's Guardian Press, 2016.
7. Chen Y, Chen G. Introduction and comparison of several diagnostic criteria and scales of mental retardation[J]. Chinese Journal of Applied Chinical Pediatrics 2007;12:958-60.
8. Goldenberg RL, Culhane JF, lams JD, et al. Epidemiology and causes of preterm birth. The Lancet 2008;371:75-84.
9. You J, Wang S, Wnag J. Monitoring of the neuropsychological behavior development in preterm and low birth weight infants[J].Chinese Journal of Child Health Care 2016;06:662-4.
10. Zhou W. Retrospective analysis of major clinical problems in very preterm infants and preparation of human umbilical cord blood mesenchymal stem cells D. Pediatric of Southern Medical University,2013.
11. Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet 2008;371:261-9.
12. Wei X, Han Y. Progress of research on early intervention of preterm infants in China[J]. Chinese Journal of Reproductive Health2003;14:254-5.
13. Johnson S, Strauss V, Gilmore C, et al. Learning disabilities among extremely preterm children without neurosensory impairment:Comorbidity, neuropsychological profiles and scholastic outcomes.Early Hum Dev 2016;103:69-75.
14. Johnson S, Wolke D, Hennessy E, et al. Educational outcomes in extremely preterm children:neuropsychological correlates and predictors of attainment. Dev Neuropsychol 2011;36:74-95.
15. Vanderveen JA, Bassler D, Robertson CM, et al. Early interventions involving parents to improve neurodevelopmental outcomes of premature infants:a meta-analysis. J Perinatol 2009;29:343-51.
2. Vohr B. Long-term outcomes of moderately preterm, late preterm,and early term infants. Clin Perinatol 2013;40:739-51.
3. Spittle A, Orton J, Anderson PJ, et al. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants. Cochrane Database Syst Rev 2015;(11):CD005495.
4. Tian Y, Zhang Y, Chen F, et al. The effect of multidisciplinary management system of preterm infants on the neurodevelopmental outcomes of preterm infants discharged from neonatal intensive care unit[J]. Chinese Journal of Child Health Care 2018;26:294-7.
5. Xu S, Huang H, Zhang J. The progress of research and application of diagnostic developmental evaluation scale for infants[J]. Chinese Journal of Child Health Care 2010;11:859-61.
6. Yang Y. Children's Developmental Rating Scale M. 1. Beijing:People's Guardian Press, 2016.
7. Chen Y, Chen G. Introduction and comparison of several diagnostic criteria and scales of mental retardation[J]. Chinese Journal of Applied Chinical Pediatrics 2007;12:958-60.
8. Goldenberg RL, Culhane JF, lams JD, et al. Epidemiology and causes of preterm birth. The Lancet 2008;371:75-84.
9. You J, Wang S, Wnag J. Monitoring of the neuropsychological behavior development in preterm and low birth weight infants[J].Chinese Journal of Child Health Care 2016;06:662-4.
10. Zhou W. Retrospective analysis of major clinical problems in very preterm infants and preparation of human umbilical cord blood mesenchymal stem cells D. Pediatric of Southern Medical University,2013.
11. Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet 2008;371:261-9.
12. Wei X, Han Y. Progress of research on early intervention of preterm infants in China[J]. Chinese Journal of Reproductive Health2003;14:254-5.
13. Johnson S, Strauss V, Gilmore C, et al. Learning disabilities among extremely preterm children without neurosensory impairment:Comorbidity, neuropsychological profiles and scholastic outcomes.Early Hum Dev 2016;103:69-75.
14. Johnson S, Wolke D, Hennessy E, et al. Educational outcomes in extremely preterm children:neuropsychological correlates and predictors of attainment. Dev Neuropsychol 2011;36:74-95.
15. Vanderveen JA, Bassler D, Robertson CM, et al. Early interventions involving parents to improve neurodevelopmental outcomes of premature infants:a meta-analysis. J Perinatol 2009;29:343-51.