单胎足月新生儿行为神经测评影响因素分析

目的测定和评估足月新生儿行为神经能力并探讨其影响因素,为早期发现新生儿大脑发育异常和早期干预提供科学依据。方法采用新生儿20项行为神经评分测定(neonatal behavior neurological assessment,NBNA)量表对2010年12月至2013年5月在甘肃省民乐县妇幼保健院分娩的单胎足月新生儿3 035例,在出生后3 d进行行为神经能力测定和评估,分析新生儿行为神经测评评分的影响因素。结果 NBNA异常率(评分≤35分)足月单胎新生儿为19.67%,足月低出生体重儿为75.53%。多因素Logistic回归分析发现,低出生体重(OR=17.39,95%CI:10.36~29.20)和较大孕周(OR=1.12,95%CI:1.02~1.23)可增加NBNA异常风险,而母亲具有大学以上文化程度使风险降低(OR=0.41,95%CI:0.21~0.81)。结论低出生体重是引起单胎足月新生儿NBNA异常的重要因素,而母亲文化程度高将减少NBNA异常率。

Analysis on influencing factors of neonatal behavior neurological assessment in single full term neonates

Objective To identify influencing factors of neonatal behavioral and neurological ability （NBNA） assessment in single full term neonates. To provide evidence for detection and intervention of abnormal brain growth in neonates. Methods A total of 3 035 single full term neonates were evaluated at 3 days after birth in Minle County Maternal and Child Health Hospital from Dec. 2010 to May 2013. NBNA （20 items） was used to evaluate the behavioral and neurological ability. Results The NBNA unqualified rate was 19. 60% , while 75.53% for low birth weight neonates. By multiple logistic regression analysis, risk factors for unqualified NBNA were low birth weight and long gestational weeks, with OR of 17.39 （ 95 % CI： 10. 36 - 29. 20 ） and 1.12 （95 % CI： 1.02 1.23 ） respectively. Mother with advance education were more unlikely for unqualified NBNA （ OR = O. 41,95% CI： O. 21 - 0. 81 ）. Conclusion Low birth weight is an important risk factor for unqualified NBNA, and mother with advanced education could reduce NBNA unqualified rate.