摘要
目的探讨小于胎龄(SGA)儿生后早期脑发育状况及18~24月龄时神经发育水平,为临床上完善SGA的诊疗及早期干预提供参考依据。方法选择2019年1月—2020年12月在濮阳市妇幼保健院出生,且出院后定期在儿童保健门诊随访的病例为研究对象,按胎龄及出生体重分为早产SGA组、早产适于胎龄(AGA)组、足月SGA组和足月AGA组,比较4组出生后24~48h内头颅超声测量胼胝体长度、胼胝体-顶点长度、小脑蚓部高度和小脑蚓部前后径值,以及校正胎龄18~24月龄时神经发育水平,同时分析SGA对神经发育的影响。结果4组间小脑蚓部高度差异有统计学意义(F=5.214,P<0.05),其中早产SGA、早产AGA和足月SGA组小脑蚓部高度均落后于足月AGA组,且早产SGA组落后于早产AGA和足月SGA组(P<0.05);4组间18~24月龄时适应性(F=10.152)、大运动(F=16.842)、精细动作(F=5.256)、语言(F=12.387)和个人社交发育商(F=7.963)差异均有统计学意义(P<0.05),其中早产SGA组语言和个人社交发育较早产AGA组落后,且适应性、大运动、精细动作、语言和个人社交发育均落后于足月AGA,而足月SGA组大运动和语言发育落后于足月AGA组。与足月AGA组相比,早产SGA组大运动(OR=2.895,95%CI:1.896~5.691)和语言发育(OR=4.026,95%CI:1.124~13.264)落后风险增加(P<0.05),而足月SGA大运动发育落后的风险增加(OR=1.259,95%CI:1.084~2.169,P<0.05)。结论SGA儿生后可能出现脑发育异常,且在18~24月龄时神经发育水平落后于AGA儿,即便是足月SGA儿同样存在神经发育异常的高风险,临床应重视其随访管理及早期干预。
Objective To investigate the postnatal brain development and neurdevelopment at the age of 18to 24 months in small gestational age(SGA)infants,in order to provide reference for follow-up and early intervention of SGA.Methods Neonates born in Puyang Maternal and Child Health Hospital from January 2019to December 2020and regularly followed up in the child health care clinic after discharge were selected as study subjects.According to gestational age and birth weight,neonates were divided into four groups:Premature SGA,premature appropriate gestational age(AGA),fullterm SGA and full-term AGA.Cranial ultrasound was used to measure the corpus callosum length,corpus callosumfastigium length,cerebellar vermis height,and cerebellar vermis anteroposterior diameter of the neonates within 24to 48 hours.The neurdevelopment at the age of 18to 24months was assessed,and the effect of SGA on neurdevelopment was analyzed.Results There were statistically significant differences in vermis height between the four groups(F=5.214,P<0.05).The vermis height of premature SGA,premature AGA and full-term SGA infants were all lower than that of full-term AGA infants,which was higher in preterm AGA and full-term SGA infants than preterm SGA infants.There were statistically significant differences in adaptability(F=10.152),gross motor(F=16.842),fine motor(F=5.256),language(F=12.387)and personal social development quotient(DQ)(F=7.963)between the four groups at 18to 24 months of age(P<0.05).The language and personal social DQ of premature SGA infants was lower that of premature AGA infants,and the adaptation,gross motor,fine motor,language and personal social development were behind that of full-term AGA infants.However,full-term SGA laged behind full-term AGA in gross motor and language development.Compared with full-term AGA,premature SGA had an increasing risk of gross motor(OR=2.895,95%CI:1.896-5.691,P<0.05)and language development retardation(OR=4.026,95%CI:1.124-13.264,P<0.05),while full-term SGA had an increasing risk of gross motor dev
作者
王晓庆
刘九月
姚光
WANG Xiaoqing;LIU Jiuyue;YAO Guang(Department of Pediatrics,Puyang Maternal and Child Health Hospital,Puyang,Henan 457000,China)
出处
《中国儿童保健杂志》
CAS
CSCD
2023年第4期353-358,共6页
Chinese Journal of Child Health Care
关键词
小于胎龄儿
脑发育
神经行为发育
随访
早期干预
small for gestational age
brain development
neurdevelopment
follow-up
early intervention
