Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in ...Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants.The aspects and extent to which the home environment affects the early(18 months corrected age)neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit(NICU).It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study,275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children's Hospital.The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient(evaluated by the Gesell Developmental Scale)and the rate of developmental delays at 18 months corrected age.Results A total of 41.454%of the infants were extremely preterm.The developmental quotient scores at 18 months corrected age were in the middle of the scale.The language domain had the highest rate of developmental delay(46.182%),followed by the adaptive domain(37.091%).Multiple logistic regression analyses showed that compared with infants in supportive home environments,infants with moderate/unsupportive home environments had significantly elevated risks of development delay:2.162-fold for global(odds ratio(OR)2.162,95% confidence interval(Cl)1.274 to 3.665,p=0.004),2.193-fold for fine motor(OR 2.193,95%CI 1.161 to 4.140,p=0.016),2.249-fold for language(0R 2.249,95%CI 1.336 to 3.786,p=0.002)and 2.042-fold for personal-social(OR 2.042,95%CI 1.149 to 3.628,p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants.It is associated with higher developmental quotient scores and protects against neuropsychiatric delays.Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.展开更多
目的探讨小于胎龄儿(small for gestational age infant,SGA)校正12~24月龄神经心理发育现状及影响因素。方法回顾性收集2018年4月—2023年12月深圳市宝安区妇幼保健院754例校正12~24月龄SGA儿童的临床资料,分析其发育商(developmental ...目的探讨小于胎龄儿(small for gestational age infant,SGA)校正12~24月龄神经心理发育现状及影响因素。方法回顾性收集2018年4月—2023年12月深圳市宝安区妇幼保健院754例校正12~24月龄SGA儿童的临床资料,分析其发育商(developmental quotient,DQ)水平,根据是否发生全面发育迟缓(global developmental delay,GDD)分为GDD组(71例)和对照组(683例),探讨其发生率及影响因素。结果高危早产SGA总DQ及各能区DQ均落后于足月SGA(P<0.017)。GDD总体发生率为9.4%(71/754),胎龄越小,发生率越高(P<0.017)。GDD组男性、低危及高危早产儿、母亲学历为本科以下、多胎、新生儿低血糖、新生儿肺炎、新生儿呼吸窘迫综合征、支气管肺发育不良,以及校正12~24月龄时低体重、生长迟缓、小头的比例高于对照组,新生儿住院时长长于对照组(P<0.05),而出生及校正12~24月龄时年龄别体重Z值、年龄别身长Z值、头围Z值低于对照组(P<0.05)。多因素logistic回归分析显示,男性、母亲学历为本科以下是SGA发生GDD的独立危险因素(P<0.05)。结论早产SGA神经心理发育水平相对落后,母亲学历为本科以下的男性SGA应予重点关注。展开更多
基金funded by Shanghai Municipal Health and Wellness Commission Health Industry Clinical Research Special Project(202140299).
文摘Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants.The aspects and extent to which the home environment affects the early(18 months corrected age)neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit(NICU).It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study,275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children's Hospital.The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient(evaluated by the Gesell Developmental Scale)and the rate of developmental delays at 18 months corrected age.Results A total of 41.454%of the infants were extremely preterm.The developmental quotient scores at 18 months corrected age were in the middle of the scale.The language domain had the highest rate of developmental delay(46.182%),followed by the adaptive domain(37.091%).Multiple logistic regression analyses showed that compared with infants in supportive home environments,infants with moderate/unsupportive home environments had significantly elevated risks of development delay:2.162-fold for global(odds ratio(OR)2.162,95% confidence interval(Cl)1.274 to 3.665,p=0.004),2.193-fold for fine motor(OR 2.193,95%CI 1.161 to 4.140,p=0.016),2.249-fold for language(0R 2.249,95%CI 1.336 to 3.786,p=0.002)and 2.042-fold for personal-social(OR 2.042,95%CI 1.149 to 3.628,p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants.It is associated with higher developmental quotient scores and protects against neuropsychiatric delays.Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.
文摘目的探讨小于胎龄儿(small for gestational age infant,SGA)校正12~24月龄神经心理发育现状及影响因素。方法回顾性收集2018年4月—2023年12月深圳市宝安区妇幼保健院754例校正12~24月龄SGA儿童的临床资料,分析其发育商(developmental quotient,DQ)水平,根据是否发生全面发育迟缓(global developmental delay,GDD)分为GDD组(71例)和对照组(683例),探讨其发生率及影响因素。结果高危早产SGA总DQ及各能区DQ均落后于足月SGA(P<0.017)。GDD总体发生率为9.4%(71/754),胎龄越小,发生率越高(P<0.017)。GDD组男性、低危及高危早产儿、母亲学历为本科以下、多胎、新生儿低血糖、新生儿肺炎、新生儿呼吸窘迫综合征、支气管肺发育不良,以及校正12~24月龄时低体重、生长迟缓、小头的比例高于对照组,新生儿住院时长长于对照组(P<0.05),而出生及校正12~24月龄时年龄别体重Z值、年龄别身长Z值、头围Z值低于对照组(P<0.05)。多因素logistic回归分析显示,男性、母亲学历为本科以下是SGA发生GDD的独立危险因素(P<0.05)。结论早产SGA神经心理发育水平相对落后,母亲学历为本科以下的男性SGA应予重点关注。
