低出生体重儿婴儿期神经精神发育纵向研究

目的 纵向随访合肥市主城区低出生体重儿0～12月神经精神发育状况,为开展生长发育监测和早期干预提供参考依据。方法 2012年9月-2013年9月建立低出生体重儿(LBWI)出生队列,共纳入228名低出生体重儿,并在同地区同一时间段的儿童保健系统中选取161名正常出生体重儿(NBWI)作为对照组,在6、9、12月龄时对所有婴儿进行智能发育评估。结果 LBWI在6、9、12月龄时,智能发育指数(79.4±16.2 vs 93.5±13.3,85.6±11.7 vs 93.5±8.6,79.7±13.3 vs 86.9±13.0)和运动发育指数(78.1±12.1 vs 88.9±9.1,79.8±16.5 vs 92.3±13.6,79.3±14.6 vs 90.8±13.8)显著低于NBWI组,差异有统计学意义(P<0.05);1岁内LBWI发育迟缓发生率在10.7%～37.5%之间,发育偏离发生率达12.7%～29.8%,明显高于NBWI(分别在10%和15%以下),差异有统计学意义(P<0.01);LBWI在婴儿期神经精神发育追赶不明显,尤其是运动发育较缓慢。结论 低出生体重对婴儿神经精神发育存在不良影响,LBWI在1周岁时仍不能达到正常出生体重儿童的发育水平,应关注LBWI婴儿期的早期干预,并随访监测LBWI 生后的神经精神发育状况。

Longitudinal study on neuropsychological development for low weight birth infants

Objective To monitor neuropsychological development of low birth weight infants (LBWI) during 0‵12 months in Hefei,and to provide a reference basis of growth monitoring and early intervention for LBWI. Methods The birth cohort of LBWI was established from September 2012 to September 2013,and a total of 228 LBWIs were selected into the cohort.Totally 161 normal birth weight infants(NBWI) born at the same time in the same area were selected as control group.Intelligence development of all infants were assessed at the age of 6,9 and 12 months. Results The average scores of mental development index (79.4±16.2 vs 93.5±13.3,85.6±11.7 vs 93.5±8.6,79.7±13.3 vs 86.9±13.0) and psychomotor development index (78.1±12.1 vs 88.9±9.1,79.8±16.5 vs 92.3±13.6,79.3±14.6 vs 90.8±13.8) of LBWI were significantly lower than NBWI at the age of 6,9 and 12 months in both male and female (P<0.05).The ratios of developmental delay (10.7%‵37.5%)and development deviate(12.7%‵29.8%) in LBWI group (under 10% and 15% respectively)were significantly higher than those of NBWI group,and the difference was statistically significant (P<0.01).The neuropsychologic development for LBWI in infancy had not grown up obviously,especially the psychomotor development was relatively slower. Conclusion Low birth weight is one of the risk factors for neuropsychologic development of infants.The neuropsychologic development level of LBWI can not reach that of NBWI in the first year of life.It is supposed to focus on early intervention for LBWI during infancy,and to continue the monitoring of the neuropsychologic development after birth.