不安运动阶段影响婴儿全身运动质量的影响因素分析

目的分析影响婴儿不安运动阶段全身运动(GMS)质量的相关因素,为临床干预提供理论依据。方法选取2015年7月-2018年4月接受GMs评估且处于不安运动阶段的高危小婴儿719例,其中,GMs评估正常组571例,异常组148例。对可能会影响小婴儿GMs质量的产前、产时、产后发生的21种危险因素进行调查。结果单因素分析显示,GMs异常组婴儿出生体重明显低于正常组(P<0.01);而出生胎龄(<30周)、新生儿窒息、缺氧缺血性脑病、新生儿高胆红素血症、颅内出血、新生儿惊厥的比率明显高于正常组(P<0.05)。Logistic回归分析显示,有统计学意义的影响因素有出生体重(OR=0.645,95%CI:0.474～0.878)、出生胎龄(<30周)(OR=4.05,95%CI:1.565～10.484)、缺氧缺血性脑病(OR=3.152,95%CI:1.765～5.629)、新生儿高胆红素血症(OR=5.07,95%CI:3.161～8.132)、新生儿惊厥(OR=3.579,95%CI:1.572～8.146)。结论出生胎龄(<30周)、缺氧缺血性脑病、新生儿高胆红素血症、新生儿惊厥是影响不安运动阶段婴儿GMs质量的独立危险因素,而出生体重是保护因素;对存在此类高危因素的小婴儿,应给予早期筛查及干预。

Analysis of influencing factors influencing the quality of general movements in infants during the period of fidgety movements

Objective To analyze the risk factors influencing the quality of general movements (GMs) in infants during the period of fidgety movements, in order to provide scientific basis for clinical treatment. Methods A total of 719 high-risk infants receiving GMs assessment from July 2015 to April 2018 and at the stage of fidgety movements were enrolled in this study, including 571 cases of normal group and 148 cases of abnormal group by GMs assessment.Data on risk factors of antenatal, intrapartum and postpartum that may affect the quality of GMs in infants were investigated and collected. Results Single factor analysis showed that the birth weight of the abnormal group was significantly lower than that of the normal group (P<0.01), while the rates of gestational age (<30 weeks), neonatal asphyxia, hypoxic ischemic encephalopathy, neonatal hyperbilirubinemia, intracranial bleeding, and neonatal convulsions of the abnormal group were significantly higher than those of the normal group(P<0.05).Bivariate Logistic regression analysis indicated that birth weight(OR=0.645,95%CI:0.474-0.878)、gestational age(<30 weeks) (OR=4.05,95%CI:1.565-10.484)、hypoxic ischemic encephalopathy (OR=3.152,95% CI:1.765-5.629)、neonatal hyperbilirubinemia (OR=5.07,95%CI:3.161-8.132)、neonatal convulsions (OR=3.579,95%CI:1.572-8.146) were influencing factors for low quality of GMs in the stage of fidgety movements. Conclusions Gestational age under 30 weeks, hypoxic ischemic encephalopathy, neonatal hyperbilirubinemia and neonatal convulsions are risk factors for abnormal GMs results in infants during the period of fidgety movements, and tow birth weight is protective factor.Early screening and intervention should be performed to the infants with such high risk factors.