早产儿408例体格生长与神经运动发育纵向研究

目的 分析早产对婴儿体格生长与运动发育的影响,为改善早产儿的神经运动发育提供依据。方法 以广西钦州市妇幼保健院新生儿科住院且出院后定期随访、资料完整的408例早产儿为研究对象,收集校正胎龄40周、6月龄、12月龄的头围、体重,校正胎龄40周的新生儿行为神经测查(NBNA)评分和校正6月龄、12月龄Gesell量表发育商;比较体格增长迟缓组和正常组婴儿各月龄段相应的体格增长与神经运动发育的情况。结果 体格增长迟缓的发生率在校正胎龄40周时最高(21.8%),校正12月龄较6月龄显著下降(4.9% vs. 8.6%)。校正12月龄大运动异常的发生率较6月龄显著下降(7.6% vs.16.4%),各月龄段体格增长迟缓者神经运动异常的发生率显著增高,差异有统计学意义(P＜0.05)。结论 大部分早产儿校正12月龄时已实现体格追赶性生长和神经运动的良好发育,校正12月龄的体格增长迟缓是发生大运动异常的危险因素。

Longitudinal study of physical growth and neuromotor development in preterm infants

Objective To analyze the influence of preterm on physical growth and neuromotor development in infants, in order to provide evidence for improving motor development. Methods A total of 408 preterm infants with detailed case data in Neonatology Department of Qinzhou Maternal and Child Health Care Hospital were enrolled in this follow-up study. The head circumferences and body weights at corrected age of 40 weeks, 6 and 12 months were collected. Also, the score of Neonatal Behavioral Neurological Assessment (NBNA) at corrected age of 40 weeks and the development quotient in Gesell Developmental Scale at gestation-adjusted age of 6 and 12 months were collected. Comparison on physical growth and neuromotor development between physical growth retardation group and normal growth group was made. Results The incidence of physical growth retardation at corrected age of 40 weeks was the highest (21.8%), and was significantly lower at the age of 12 months than that at the age of 6 months. The incidence of impaired gross motor development at corrected age of 12 months was significantly lower than that at corrected age of 6 months (7.6% vs 16.4%). The infants with physical growth retardation had significantly higher incidences of neuromotor developmental delay at the three time points (P＜0.05). Conclusions Most preterm infants had achieved catch-up growth in physique and good development in neuromotor at corrected age of 12 months. Physical growth retardation at corrected age of 12 months is a risk factor for abnormal gross motor development.