摘要
目的探讨晚期早产儿和早期足月儿1岁时的神经心理发育水平。方法选择矫正年龄为1岁的1?257名儿童为研究对象。根据其出生时胎龄分为4组:早期早产儿(胎龄28~33+6周)、晚期早产儿(胎龄34~36+6周)、早期足月儿(胎龄37~38+6周)及完全足月儿(胎龄39~41+6周)。采用Gesell发展量表评估其神经心理发育水平,比较各组儿童在1岁时神经心理发育状况。结果4组儿童1岁时5大能区(适应性、大运动、精细动作、语言、个人社交)发育商的差异均有统计学意义(P<0.05),且均表现为完全足月儿>早期足月儿>晚期早产儿>早期早产儿的趋势(P<0.05);各能区发育迟缓率也均表现为完全足月儿最低,早期早产儿最高(P<0.05)。与完全足月儿相比,早期足月儿适应能力发育落后的风险增加(OR=1.796,P<0.05);晚期早产儿适应能力和精细动作发育落后的风险较高,OR值分别为2.651、2.679(P<0.05);早期早产儿适应能力、精细动作和个人社交能力发育落后的风险较高,OR值分别为4.069、3.710、3.515(P<0.05)。结论儿童1岁时神经心理发育落后的风险随出生胎龄的增加而降低,呈现剂量反应效应。早期足月儿和晚期早产儿仍然存在不同程度的发育落后,应重视早期足月儿和晚期早产儿的保健随访。
Objective To study the level of neuropsychological development in late preterm infants and early term infants at the age of 1 year.Methods A total of 1?257 children with a corrected age of 1 year were enrolled as subjects.According to gestational age at birth,they were divided into an early preterm group(28-33+6 weeks),a late preterm group(34-36+6 weeks),an early term group(37-38+6 weeks),and a full-term group(39-41+6 weeks).Gesell Developmental Schedules were used to assess the neuropsychological development of the children,and the groups were compared in terms of neuropsychological development at the age of 1 year.Results There were significant differences in the developmental quotients of the five functional areas(adaptability,gross motor,fine motor,language and social ability)between the four groups at the age of 1 year(P<0.05),and the full-term infants had the highest development quotients,followed by the early term infants,the late preterm infants,and the early preterm infants(P<0.05).The full-term infants had the lowest rate of developmental delay in each functional area,while the early preterm infants had the highest rate(P<0.05).Compared with the full-term infants,the early term infants had a higher risk of developmental delay in adaptability(OR=1.796,P<0.05),and the late preterm infants had a higher risk of developmental delay in adaptability(OR=2.651,P<0.05)and fine motor(OR=2.679,P<0.05),while the early preterm infants had a higher risk of developmental delay in adaptability(OR=4.069,P<0.05),fine motor(OR=3.710,P<0.05),and social ability(OR=3.515,P<0.05).Conclusions The risk of neuropsychological developmental delay decreases with the increase in gestational age in children at the age of 1 year,with a dose-response effect.There are varying degrees of developmental delay in early term infants and late preterm infants,and health care follow-up for early term infants and late preterm infants should be taken seriously.
作者
梁晶晶
胡艳
邢艳菲
林穗方
宋燕燕
LIANG Jing-Jing;HU Yan;XING Yan-Fei;LIN Sui-Fang;SONG Yan-Yan(Department of Child Health Care,Guangzhou Women and Children’s Medical Center,Guangzhou Medical University,Guangzhou 510623,China)
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2020年第7期706-710,共5页
Chinese Journal of Contemporary Pediatrics
基金
广东省科技计划项目(2017A020214002)。
关键词
神经心理发育
发育商
早期足月儿
晚期早产儿
Neuropsychological development
Developmental quotient
Early term infant
Late preterm infant
