Motor performance and behaviour in preterm and full-term 3-year-old children

AIM: To compare the motor performance and behaviour at 3 years of age of very preterm, moderately preterm and full-term children (n = 221), who needed neonatal intensive care (NIC), and of 72 neonatally healthy full-term children (reference group). METHOD: A model for combined assessment of motor performance and behaviour (CAMPB) was used. The children's performance was assessed on the basis of observations and documentation of categories of co-ordination, attention and social behaviour included in CAMPB. RESULTS: Significantly more very preterm children showed deviations in co-ordination than children in the other groups, and this difference was most evident in comparison with the reference group. No differences were found between the groups regarding attention and social behaviour during the assessment. CONCLUSION: Very preterm children differ from moderately preterm and full-term children in their motor performance at 3 years of age. By means of CAMPB, individual children with pronounced incoordination were identified in all groups, and some of them also showed pronounced lack of attention.     

Associations of motor co-ordination and attention with motor-perceptual development in 3-year-old preterm and full-term children who needed neonatal intensive care

BACKGROUND: Children who have needed neonatal intensive care (NIC) are considered to be at risk for deficits such as developmental co-ordination disorder and attention-deficit/hyperactivity disorder. By assessing motor-perceptual development, motor co-ordination and attention already at 3 years of age, it might be possible to identify such deficits earlier than they are today. AIM: To investigate the motor-perceptual development in a group of 202 NIC children but had no major impairments, to describe associations of deficits in co-ordination and attention with motor-perceptual delays, and to estimate the prevalence of NIC children with combined deficits together with a motor-perceptual delay. METHOD: Co-ordination and attention in children born very preterm (n = 57), moderately preterm (n = 75) and full-term (n = 70) were observed according to a model for Combined Assessment of Motor Performance and Behaviour while they were assessed using a developmental scale, Motor-Perceptual Development, 0-7 years, MPU. RESULTS: In two out of 14 MPU areas, a larger proportion of very preterm than of moderately preterm and full-term children had marked developmental delay. Overall, the proportion of NIC children having a motor-perceptual delay increased with increasing incoordination and especially increasing lack of attention. Twenty-one (11%) of the NIC children had different motor-perceptual delays combined with pronounced incoordination and pronounced lack of attention. CONCLUSION: Deficits in co-ordination and attention were associated with motor-perceptual delays in areas important for daily living and development of academic skills. Therefore, to find children at risk for developmental co-ordination disorder and attention-deficit/hyperactivity disorder, assessments of co-ordination and attention should be added to assessments of motor-perceptual development in 3-year-old NIC children.     

Deficits in motor co-ordination and attention at 3 years of age predict motor deviations in 6.5-year-old children who needed neonatal intensive care

Background   A total of 189 children without major impairments who needed neonatal intensive care (NIC) were followed up at ages 3 and 6.5 years.
Aim   To determine the prevalence of different motor deviations at age 6.5 years and the co-occurrence of attention deficits; also, to analyse the predictive ability of motor co-ordination and attention assessments at age 3 years for motor deviations at 6.5 years.
Method   A combined assessment of motor performance and behaviour (CAMPB) was used at the 3-year examination. The Test of Motor Impairment (TOMI) and the Motor-Perceptual Development (MPU) were used together with the criteria of the diagnostic and statistical manual of mental disorders (DSM-IV-TR) to define motor deviations.
Results   At 6.5 years 64% of the children showed a motor deviation either as a delay according to MPU, a problem according to TOMI or Developmental Coordination Disorder (DCD) according to DSM-IV-TR. Higher proportions of children with attention deficit (50%) were found in the DCD group. The predictive ability of CAMPB was analysed in two ways: when all children with either a co-ordination or attention deficit, or both, at 3 years were considered to be at risk for motor deviations at 6.5 years, the sensitivity reached 78% and the specificity was 42%. But when only the 3 year olds with a combined deficit were considered to be at risk, the sensitivity was 37% and the specificity 89%; however, a positive predictive value of 86% was reached.
Conclusion   At 6.5 years of age a majority of NIC children with no major impairments showed motor deviations. To fulfil the DCD criteria in DSM-IV-TR, a strict definition of motor deviations is recommended. Attention deficits are more prevalent among children with DCD. Deficits in motor co-ordination and/or attention in 3-year-old children are strong predictors of motor deviations and, especially, of DCD at 6.5 years of age.     

The course of physical development of children born premature

Physical development of 474 preterm (born at 30-37 weeks) children was evaluated in infancy (n = 157), preschool (n = 154), and school (n = 163) age. Small-for-date children and children corresponding to their gestation age were retrospectively distinguished. Control group consisted of 474 age and sex-matched children born after full-term gestation. Physical health status of preterm children of early, preschool, and school age is characterized by specific structural and dynamic features, qualitatively and quantitatively differing from the values in full-term controls. With aging, the effect of medical psychosocial risk factors on physical development decreases.     

不同出生胎龄对婴幼儿神经行为能力影响的研究

目的 探索不同出生胎龄对婴幼儿运动、认知等神经行为能力的影响,为二孩政策后儿童保健服务模式的调整提供线索。方法 通过方便抽样的方法,采用贝莉Ⅲ筛查量表对上海某区医院2017年1-4月体检的婴幼儿(2 646例)进行调查。结果 高龄母亲和非高龄母亲组分娩儿童的大运动、精细运动和认知能力差异均有统计学意义(t=2.94、2.80、2.68,P<0.05);通过多因素Logistic分析,调整母亲分娩年龄、性别、出生体重和不同胎龄因素,结果显示早产儿大运动落后风险是足月儿的1.960倍(OR=1.960,95%CI:1.264~3.037),早期儿精细运动落后风险是足月儿的1.192倍(OR=1.192,95%CI:1.006~1.412)。结论 与足月儿相比,早产儿发生大运动落后风险增加,早期儿发生精细运动落后风险增加。     

The probability of giving birth among women who were born preterm or with impaired fetal growth: a Swedish population-based registry study

The primary aim of this study was to investigate whether women born prematurely or with impaired fetal growth have a reduced probability of giving birth. Using Swedish population-based registries, the authors identified 148,281 women born in 1973-1975 for follow-up until 2001. Of these women, 4.1% were born preterm and 0.32% very preterm, 0.29% were born with a very low birth weight, and 5.4% were small for gestational age. Outcome measures were the hazard ratios for giving birth during the study period. Adjustments were made for socioeconomic factors. Very-low-birth-weight women displayed a reduced probability of giving birth (hazard ratio = 0.74, 95% confidence interval: 0.60, 0.91), most apparent among women aged 25 or more years. There were also tendencies of reduced hazard ratios of giving birth among women born preterm or very preterm in this age interval. Women born small for gestational age (below -2 standard deviations) seemed to be more likely to have given birth (hazard ratio = 1.09, 95% confidence interval: 1.04, 1.14), but when a more extreme group of small-for-gestational-age women (below -3 standard deviations) was defined, the association was less evident (hazard ratio = 1.04, 95% confidence interval: 0.94, 1.16). The results suggest that very-low-birth-weight women and, possibly, women born preterm or very preterm have a reduced probability of giving birth, while the results regarding small for gestational age are less clear.     

Similar relative risks of seizures following measles containing vaccination in children born preterm compared to full-term without previous seizures or seizure-related disorders

Background

Febrile seizures are associated with the first dose of measles-containing vaccines and the risk increases with chronologic age during the second year of life. We used the Vaccine Safety Datalink (VSD) to determine if the relative increase in risk of seizures following receipt of measles-containing vaccine differs by gestational age at birth.

不同出生胎龄对婴幼儿神经行为能力影响的研究

目的 探索不同出生胎龄对婴幼儿运动、认知等神经行为能力的影响,为二孩政策后儿童保健服务模式的调整提供线索。方法 通过方便抽样的方法,采用贝莉Ⅲ筛查量表对上海某区医院2017年1-4月体检的婴幼儿(2 646例)进行调查。结果 高龄母亲和非高龄母亲组分娩儿童的大运动、精细运动和认知能力差异均有统计学意义(t=2.94、2.80、2.68,P<0.05);通过多因素Logistic分析,调整母亲分娩年龄、性别、出生体重和不同胎龄因素,结果显示早产儿大运动落后风险是足月儿的1.960倍(OR=1.960,95%CI:1.264~3.037),早期儿精细运动落后风险是足月儿的1.192倍(OR=1.192,95%CI:1.006~1.412)。结论 与足月儿相比,早产儿发生大运动落后风险增加,早期儿发生精细运动落后风险增加。     

早产儿早期神经运动发育纵向随访

目的 探讨早产对婴幼儿智力、运动发育及视觉认知能力的影响,为开展早产儿早期干预提供依据。方法 采用纵向随访方法,选取曾在本院新生儿科住院的55例早产儿(其中:极早产儿 25例,中晚期早产儿30例)作为研究组,40例正常足月儿作为对照组,应用Bayley-Ⅱ婴幼儿发育量表在12月龄、18月龄、24月龄和36月龄时进行评估,用智力发育指数(Mental Developmental Index,MDI)、运动发育指数(Psychomotor Developmental Index,PDI)和视觉项目通过率表示。结果 极早产儿各校正月龄MDI、PDI均较正常足月儿落后(P＜0.05);中晚期早产儿仅在校正12月龄和24月龄MDI得分与对照组存在显著性差异(P＜0.05),各校正月龄PDI得分与对照组无显著性差异(P＞0.05)。极早产儿组视觉项目通过率为46.3%,中晚期早产儿为61.5%,对照组为74.4%。 结论 早产对婴幼儿的智力、运动及视觉认知发育存在显著负面影响,在极早产儿中尤为明显,应尽早实施早期干预,促进早产儿发育。     

早产儿与足月儿早期神经运动发育的差异性分析

目的 对比早产儿与足月儿早期0~1岁神经运动20项检查(INMA20)结果的差异,为神经发育异常患儿的早发现、早干预提供新思路。方法 选择2020年1月1日—12月31日出生并在四川大学华西第二医院儿童保健科建档进行连续随访的婴儿,根据孕周分为早产儿组与足月儿组,分析两组婴儿首次儿童保健时INMA20结果差异。结果 共纳入早产儿349例,足月儿713例。INMA20检查各维度结果显示早产儿视听反应维度异常率(13.5%)明显高于足月儿(8.4%)(χ²=6.683,P=0.010),足月儿肌张力维度异常率(50.9%)显著高于早产儿(44.0%)(χ²=4.517,P=0.034),两组间反射、姿势维度以及总结果,差异无统计学意义(P＞0.05)。各检查条目结果显示,早产儿的人脸追踪、内收肌角及足背屈曲异常率明显高于足月儿(χ²=7.307、3.932,P＜0.05),而足月儿持续手握拳、拉坐姿势和头竖立、围巾征异常率显著高于早产儿(χ²=5.936、11.058、6.669,P＜0.05) 。结论 早期发育中,早产儿视听整合能力、下肢肌力较弱、足月儿上肢肌力较高而头颈部肌力较弱。建议在常规儿童保健中加强视听整合训练促进早产儿视听觉追赶发育,开展不同类型的运动干预以促进婴儿粗大运动发育,同时进行早期运动发育评估尽早发现发育异常的婴儿。     

The Modified Checklist for Autism in Toddlers in extremely low gestational age newborns: individual items associated with motor, cognitive, vision and hearing limitations

The Modified Checklist for Autism in Toddlers (M-CHAT) has yielded elevated rates of screening failure for children born preterm or with low birthweight. We extended these findings with a detailed examination of M-CHAT items in a large sample of children born at extremely low gestational age. The sample was grouped according to children's current limitations and degree of impairment. The aim was to better understand how disabilities might influence M-CHAT scores. Fourteen participating institutions of the Extremely Low Gestational Age Newborns (ELGAN) Study prospectively collected information about 1086 infants who were born before the 28th week of gestation and had an assessment at age 24-months. The 24-month visit included a neurological assessment, the Bayley Scales of Infant Development, Second edition (BSID-II), M-CHAT and a medical history form. Outcome measures included the distribution of failed M-CHAT items among groups classified according to cerebral palsy diagnosis, gross motor function, BSID-II scores and vision or hearing impairments. M-CHAT items were failed more frequently by children with concurrently identified impairments (motor, cognitive, vision and hearing). In addition, the frequency of item failure increased with the severity of impairment. The failed M-CHAT items were often, but not consistently, related to children's specific impairments. Importantly, four of the six M-CHAT 'critical items' were commonly affected by presence and severity of concurrent impairments. The strong association between impaired sensory or motor function and M-CHAT results among extremely low gestational age children suggests that such impairments might give rise to false positive M-CHAT screening.     

扭动运动阶段全身运动评估与新生儿行为神经测定结果的相关分析

目的 对高危儿早期全身运动质量(GMs)评估法和新生儿行为神经测定(NBNA)方法的一致性进行分析。方法 选取2017年1月-2018年1月甘肃省妇幼保健院出生在儿童保健科随访的有高危因素的患儿,选择完成GMs扭动阶段评估,并同时进行NBNA测评的研究对象共706例。分析2种评估方法的一致性Kappa值。结果 足月、正常出生体重儿GMs评估正常检出率高于早产及低出生体重儿(P＜0.05)。早产患儿痉挛-同步性GMs检出率显著高于足月儿(P=0.043)。随着胎龄及出生体重的降低,异常的GMs检出率呈上升趋势,差异有统计学意义(P＜0.05)。不同出生胎龄及出生体重下NBNA评分与GMs评估有一定的相关性,Kappa值为0.112~0.289、0.118~0.194(P＜0.05)。结论 不同出生胎龄及出生体重下NBNA评分与GMs评估的一致性有待于进一步探讨。两种方法相互不能取代,联合应用可更全面评价高危儿脑发育及脑损伤的情况,促进患儿的运动功能及社会适应性。     

宫内发育迟缓对早产儿体格发育的影响

目的 探讨宫内发育迟缓对早产儿体格发育的影响,为早期干预提供科学依据。方法 将2015-2017年在西安市第四医院出生并在儿童保健科建立专案管理的符合入组条件的449例早产儿、作为观察组,其中小于胎龄(SGA)儿91例,适于胎龄(AGA)儿358例;同期随机抽取300名足月儿作为对照组,并对三组儿童进行体格发育监测及个体化喂养指导,随访至纠正12月龄,分析SGA组与AGA组后期生长发育迟缓发生率以及三组儿童生长速率之间是否存在不同。 结果 1)早产儿生后不同月龄体重、身长、头围生长发育迟缓发生率差异有统计学意义,并随月龄的增加呈下降趋势(χ²_SGA=24.242,46.761,9.891,P<0.05;χ²_AGA=17.536,45.763,13.829,P<0.05);2)相同月龄SGA组与AGA组体重、身长、头围生长发育迟缓发生率之间差异有统计学意义(P<0.05);3)纠正6个月以内SGA组、AGA组、足月儿组三组之间生长速率比较,差异有统计学意义(P<0.05)。结论 早产儿生后呈追赶性生长,SGA早产儿的追赶趋势最强,但有20%的SGA早产儿在1岁时仍存在体格发育迟缓。     

不同出生胎龄早产儿的智能发育水平分析

目的分析不同出生胎龄早产儿智能发育情况,为早产儿保健提供指导。方法选择自2012年2月-2015年12月在广州市妇女儿童医疗中心儿童保健科接收发育评估的2 579名婴幼儿为观察对象,分为中期早产儿(MPT)组(32~(+0/7)～33~(+6/7)周)、晚期早产儿(LPT)(34~(+0/7)～36~(+6/7)周)组、早期足月儿(ET)组(37~(+0/7)～38~(+6/7)周)和足月儿(FT)组(39~(+0/7)～40~(+6/7)周)。采用Gesell量表对所有研究对象进行神经发育水平评估,并比较各组差异。结果以FT组作为参照,MPT组、LPT组和ET组神经发育迟缓的风险增高,OR值分别为2.38(95%CI:1.18～4.78)、1.63(95%CI:1.07～2.48)、1.42(95%CI:1.12～1.81)。结论中晚期早产儿相比足月儿发生神经发育迟缓的风险比例增高,而早期足月儿同样风险比例增高,孕周与发育迟缓的风险呈现一个剂量效应。     

不同喂养方式对早产小于胎龄儿生长发育影响的研究

目的 研究不同喂养方式对小于胎龄儿体重、身长、头围的影响。方法 将215名小于胎龄儿按照喂养方式分为5组:早产儿出院后配方奶喂养组、母乳喂养组、足月儿配方奶喂养组、母乳+早产儿出院后配方奶喂养组、母乳+足月儿配方奶喂养组, 比较各组在出生、生后1、3、6、12、18月及24月体重、身长、头围等生长发育指标。结果 不同喂养方式对小于胎龄儿体重、身长、头围发育的影响有统计学意义(P<0.05), 早产儿出院后配方奶喂养组及其与母乳混合喂养组儿童发育指标优于纯母乳喂养及足月儿配方奶喂养组, 其差异有统计学意义(P<0.05)。结论 小于胎龄儿出院后应用早产儿出院后配方奶喂养或与母乳混合喂养能够促进体重、身长、头围发展, 实现小于胎龄儿的追赶生长, 避免发生宫外生长发育迟缓的发生。     

Fatty acid composition of human milk in mothers of preterm and full-term infants in the first three weeks of lactation

INTRODUCTION: It is a classical question of infant nutrition whether fatty acid composition of human milk differs in mothers of preterm as compared to those of full-term infants. AIMS AND METHODS: The authors analysed fatty acid composition of milk samples obtained five times during the first month of lactation from mothers of preterm (n = 8, gestational age: 28.0 [4.2] weeks, birthweight: 1235 [420] g, median [IQR]) and full-term (n = 10, gestational age: 38.5 [2.7] weeks, birthweight: 3375 [282] g) infants with high-resolution capillary gas-liquid chromatography. RESULTS: Maternal age, body mass index and eating habits of the mothers did not differ between the two groups. Neither did fat contents of human milk differ between the two groups. Values of linoleic (C18:2omega-6) and alpha-linolenic (C18:3omega-3) acid did not differ. Values of arachidonic acid (C20:4omega-6) and docosahexaenoic acid (C22:6omega-3) were significantly higher following preterm as compared to full-term delivery. Values of the intermediary metabolites g-linolenic acid (C18:3omega-6), dihomo-gamma-linolenic acid (C20:3omega-6), octadecanotetraenoic acid (C18:4omega-3) and eicosatrienoic acid (C20:3omega-3) were also significantly higher in human milk samples of mothers of preterm as compared to those of full-term infants. CONCLUSION: Significantly higher contribution of long-chain polyunsaturated fatty acids in breast milk of mothers giving birth to preterm as compared to full-term infants supports the concept, that preterm infants would benefit more from feeding their own mothers milk than from receiving donor milk.     

A cross-sectional study of plasma and urinary aluminum levels in term and preterm infants.

High aluminum levels have been reported in sick and intravenously fed premature infants; however, aluminum is a ubiquitous pollutant of food. This study compares the usual aluminum levels of healthy newborns from birth to the third month of life with those of enterally fed premature infants free of renal failure. Plasma and urine concentrations were determined 66 times in full-term newborns (n = 58), 56 times in a group of preterm infants whose gestational age at birth was 28 to 32 weeks (n = 36) and 54 times in another group of preterm infants whose gestational age at birth was 33 to 36 weeks (n = 50). Daily aluminum intakes (+/- SE) of the full-term infants and the two groups of preterm infants were 0.42 +/- 0.05, 0.64 +/- 0.03, and 0.52 +/- 0.03 mumol/kg per day, respectively (p = .05). Plasma aluminum levels were 0.29 +/- 0.05, 0.49 +/- 0.06, and 0.39 +/- 0.05 mumol/L (p = .007); urine excretion levels were 0.80 +/- 0.12, 0.77 +/- 0.21, and 0.78 +/- 0.2 mumol of aluminum/mmol of creatinine (p value not significant). Although the metabolic consequences of the high aluminum intakes and blood levels we have observed in very low birth weight infants remain to be assessed, these results suggest that more attention should be paid to the aluminum status and intake of healthy premature babies.     

早产儿维生素D营养状况影响因素分析

目的 研究早产儿维生素D营养状况,并探讨相关影响因素.方法 回顾性分析2011年7月-2015年10月入住南京医科大学附属无锡妇幼保健院新生儿病房的早产儿血清25(OH)D水平,以及早产儿胎龄、性别、分娩方式、出生季节、出生体重,母亲年龄、职业、婚姻状况、体质指数、受孕方式、胎产次、妊娠期并发症(包括产前发热、妊娠期高血压、妊娠期糖尿病、妊娠期肝内胆汁淤积症、胎儿生长受限)及产前激素使用情况等潜在影响.纳入同期住院的97例足月儿作为对照病例.结果 早产儿组血清25(OH)D平均水平为(36.81±16.64)nmol/L,足月儿组血清25(OH)D平均水平为(40.49±12.75)nmol/L,早产儿组显著低于足月儿组(t=-2.45,P=0.02);早产儿组维生素D严重缺乏、缺乏、不足和充足的比例分别为26.00%、53.20%、16.40%、4.30%,足月儿分别为0、76.30%、21.60%和2.10%,差异有统计学意义(Z=-3.88,P<0.01).维生素D缺乏组早产儿母亲的年龄大于偏低组(t=2.15,P=0.03),缺乏组的母亲体质指数小于偏低组(t=7.74,P<0.01),缺乏组的血钙含量低于偏低组(t=-2.31,P=0.02).夏秋季节出生早产儿维生素D营养状况好于冬春季节(χ2=6.83,P=0.01).Logistic回归分析结果示:母亲年龄(OR=1.28,95%CI:1.19~1.37,P<0.01)、母亲BMI(OR=0.82,95%CI:0.75~0.89,P<0.01)、冬春季节出生(OR=0.57,95%CI:0.33~0.97,P=0.04)为早产儿维生素D缺乏的危险因素.结论 早产儿维生素D缺乏发生率较高;母亲年龄、体质指数及冬春季节出生是早产儿维生素D缺乏的危险因素.     

Peabody运动发育量表第二版与Gesell量表评估儿童运动功能的相关性分析

目的探究不同出生情况的患儿在不同月龄段使用Peabody运动发育量表第二版(PDMS-2)与Gesell发育量表对运动功能评估结果的相关性。方法选取2016年2月-2020年7月在成都市妇女儿童中心医院康复科同时使用PDMS-2与Gesell量表进行评估的不同出生情况且月龄(纠正月龄)为3～12个月的患儿共900例(男性490例、女性410例),横纵向对比分析两种量表对不同出生情况的患儿在粗大运动和精细运动评估结果的相关性。结果极低出生体重早产儿组(ELBWI)、低出生体重早产儿组(LBWI)和足月儿组PDMS-2与Gesell量表的粗大运动以及精细运动评估结果均呈正相关(r=0.386～0.530,P<0.001)。随着月龄的增加,相关性逐渐增加,12月龄时相关性最高(ELBWI:r=0.641、0.601;LBWI:r=0.678、0.647;足月儿组:r=0.896、0.749)。足月儿PDMS-2与Gesell量表的粗大运动以及精细运动评估结果的相关性(r=0.530、0.483)高于LBWI(r=0.496、0.459)和ELBWI(r=0.449、0.386)。结论对...     

1～36个月小于胎龄儿血清脂联素水平及其与胰岛素抵抗的相关性研究

目的 探讨1～36个月小于胎龄(SGA)儿血清脂联素水平及其与胰岛素抵抗(IR)的关系.方法 选择在本院产科分娩或新生儿科住院,出生日期为2001年12月至2004年12月(收集样本时年龄为1～36个月)并被确诊为SGA的新生儿纳入SGA组(n=71).选择同期在本院儿童保健门诊接受体检的适于胎龄(AGA)儿,出生日期与SGA组一致,纳入AGA组(n=31).观察两组个体1～36个月时体格生长情况,检测其空腹血糖(FPG)、空腹胰岛素(FINS)和血清脂联素水平,计算稳态模型胰岛素抵抗指数(Hcoma-IR)和稳态模型胰岛素敏感指数(Homa-IAI).两组均排除先天性疾病、遗传代谢病、脑瘫、新生儿缺氧缺血性脑病及结核、肝炎、肾病综合征等慢性疾病患儿(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与其签署临床研究知情同意书).结果 ①SGA组71例受试者中,25例因各种原因予以排除,最终符合纳入和排除标准的SGA组受试者为46例.②SGA组与AGA组受试者性别、年龄比较,差异无统计学意义(x2=0.377,P>0.05;x2=0.064,P>0.05).另外,两组受试者生后喂养方式及纳入时合并相关内科疾病等比较,差异无统计学意义(P>0.05).③SGA组与AGA组生长发育指标比较,除体重指数(BMI),差异无统计学意义(P>0.05)外,体重、体重Z积分、身高、身高Z积分、胸围等,差异均有统计学意义(P<0.05).④SGA组和AGA组儿童的FPG,FINS,Homa-IR和Homa-IAI比较,差异均无统计学意义(P>0.05).⑤血清脂联素与BMI呈负相关(r=-0.304,P<0.05),与年龄、性别、FPG及FINS水平无相关性(P>0.05).⑥SGA组与AGA组的血清脂联素水平比较,差异有统计学意义(P<0.05),SGA组血清脂联素水平低于AGA组.⑦血清脂联素与体重、体重Z积分、身高、身高Z积分、BMI、年龄、FPG和FINS的多元线性回归分析显示,与BMI具相关性(P<0.05),是血清脂联素的影响因素,复相关系数R=0.336,确定系数R2=0.113.结论 SGA儿在1～36个月尚未出现IR,但血清脂联素水平降低,表明其出现IR的危险性高于AGA儿.