上海市高危儿神经发育情况及其影响因素分析

目的了解高危儿的神经发育现状,分析其神经发育的影响因素,为孕期教育和完善高危儿的诊疗提供理论依据。方法 2016年3月-2017年10月采用整群抽样的方法,将上海市3家妇幼保健院进行保健体检的603名高危儿及其照顾者作为研究对象,采用自行设计的问卷调查和Gesell发育诊断检查,每个能区测试结果以发育商表示。运用Logistics回归分析其神经心理发育的影响因素。结果本次研究共调查603名高危儿,年龄平均为(6.69±3.53)月,其中男童305名(50.6%),女童298名(49.4%),动作能、应物能、言语能和应人能的异常率分别为10.0%、14.9%、12.1%和8.5%。Logistics回归分析发现,在控制混杂因素后,早产、低出生体重儿、新生儿肺炎、母亲怀孕期间偶尔饮酒、母亲孕期情绪紧张是动作能发育异常的危险因素;低出生体重儿、母亲怀孕期间偶尔饮酒是应物能发育异常的危险因素;早产、母亲怀孕期间偶尔饮酒、父亲情绪紧张是言语能发育异常的危险因素;早产、母亲怀孕期间偶尔饮酒是应人能发育异常的危险因素。结论早产和低出生体重儿的脑功能发育需要加强关注,孕期饮酒和孕期父母的情绪对高危儿神经心理发育影响不可忽视。

Analysis of the neurodevelopment and its influencing factors of high-risk infants in Shanghai

Objective To investigate the current status and influencing factors for neurodevelopment of high-risk infants,in order to provide implications for pregnancy education and improving the diagnosis and treatment of high-risk infants. Methods A cross-sectional survey with cluster sampling was adopted from March 2016 to October 2017. Totally 603 high-risk infants and caregivers from three Maternal and Child Health (MCH) hospitals in Shanghai were selected as participants,questionnaire surveys and Gesell Development Diagnostic Tests were carried out. Logistic regression was used to analyze the influencing factors of neuropsychological development. Results A total of 603 high-risk infants were investigated in this study,with an average age of (6.69±3.53) months,of which 305 (50.6%) were boys and 298 (49.4%) were girls. The abnormal rates of motor development,cognition development,language development and person-skills development were 10.0%,14.9%,12.1%,and 8.5%,respectively. Logistic regression analysis showed that premature birth,low birth weight infants,neonatal pneumonia,occasional alcohol intake during pregnancy and maternal emotional stress during pregnancy were risk factors for motor development. Low birth weight infants,occasional alcohol intake during pregnancy were risk factors for cognition development. Premature birth,occasional alcohol intake during pregnancy and father's emotional stress were risk factors for language development. Premature birth and occasional alcohol intake during mother's pregnancy were risk factors for person-skills development. Conclusions Preterm infants and low birth weight infants should be given more concern on their neurodevelopment. Occasional alcohol and parents' emotional stress have negative effect on neurodevelopment.