摘要
目的探讨早产儿智能发育主要里程碑的发育年龄。方法 2015年9月—2017年9月通过便利抽样法在合肥市4个主城区(瑶海区、庐阳区、包河区、蜀山区)妇幼保健机构选取本辖区系统管理的早产儿(胎龄<37周)88例建立出生队列,胎龄<34周的早产儿为高危早产儿组,34周≤胎龄<37周的早产儿为低危早产儿组。纵向随访早产儿婴儿期智能发育主要里程碑的发育年龄,分析早产儿智能发育主要里程碑发育的实际月龄与矫正月龄,同时应用儿童心理行为发育问题预警征象监测早产儿发育状况。结果 19例早产儿失访,共随访69例,随访率为78.4%(69/88)。低危早产儿组出生体质量高于高危早产儿组,住院天数短于高危早产儿组(P<0.05)。低危、高危早产儿组各智能发育的主要里程碑出现的实际月龄均晚于正常足月儿发育的平均月龄(P<0.05);低危早产儿组逗引会发音或笑、懂得成年人面部表情、表示不要、懂得常见人和物、抬头45°、翻身、爬行、独站的矫正月龄均晚于正常足月儿发育的平均月龄(P<0.05);高危早产儿组视觉180°追踪、逗引会发音或笑、寻找声源、懂得成年人面部表情、表示不要、懂得常见人和物、抬头45°、翻身、独坐、爬行、独站的矫正月龄均晚于正常足月儿的平均月龄(P<0.05);高危早产儿组各智能发育的主要里程碑实际月龄均晚于低危早产儿组(P<0.05);高危早产儿组视觉180°追踪、懂得成年人面部表情、独坐的矫正月龄晚于低危早产儿组(P<0.05)。矫正月龄后发现,两组发育迟缓率比较,差异无统计学意义(P>0.05)。结论早产儿智能发育主要里程碑出现的实际月龄晚于正常足月儿发育的平均月龄,部分里程碑出现的矫正月龄亦晚于正常足月儿发育的平均月龄,高危早产儿尤为明显。因此,需加强对早产儿智能发育的长期监测随访和早期干预。
Objective To explore the major neuropsychological developmental milestones in premature infants during infancy by age.Methods By the convenience sampling method in a preterm birth cohort of 88 cases(gestational age less than 37 weeks)who were under systematic management of the local MCH institutions in four main urban districts of Hefei(Yaohai,Luyang,Baohe,Shushan)during September 2015 to September 2017.Gestational age<34 weeks were high-risk group,and gestational age of≥34 weeks but<37 weeks were low-risk group.We longitudinally monitored the major neuropsychological development milestones in them during infancy by age,and analyzed the differences between the chronological and corrected age for achieving these developmental milestones.Meanwhile,we monitored the outcomes of these infants using warning signs checklist for screening psychological,and behavioral developmental problems.Results Except 19 were lost to follow up,the other 69(78.4%)were included in the final analysis.There were significant differences in birth weight and inpatient treatment duration between the two groups(P<0.05).Compared with the normal full-term infants,both high-risk and low-risk groups demonstrated delayed major neuropsychological development milestones according to the chronological age(P<0.05).Moreover,even though the age of month was corrected,compared with the normal full-term infants,both high-risk and lowrisk groups still presented delayed major neuropsychological development milestones,such as vocalizations or smiling in response to teasing,understanding the adults'facial expressions,indicating“rejection”,recognizing familiar people and objects,lifting its head to a 45 degree angle,rolling over,crawling,standing independently in the low-risk group(P<0.05),and visual tracking of around 180 degrees angle,vocalizations or smiling in response to teasing,identifying sound source localization,understanding the adults'facial expressions,indicating rejection,recognizing familiar people and objects,lifting its head to a 45 degree
作者
孙瑜
段毓雯
王方军
洪心敏
李培培
高明娟
邵子瑜
SUN Yu;DUAN Yu-wen;WANG Fang-jun;HONG Xin-min;LI Pei-pei;GAO Ming-juan;SHAO Zi-yu(Maternal and Child Health Family Planning Service Center,Hefei 230001,China;Maternal and Child Health Family Planning Service Center of Baohe District,Hefei 230051,China;Maternal and Child Health Family Planning Service Center of Shushan District,Hefei 230031,China;Maternal and Child Health Family Planning Service Center of Luyang District,Hefei 230041,China)
出处
《中国全科医学》
CAS
北大核心
2018年第26期3231-3235,共5页
Chinese General Practice
基金
中国疾病预防控制中心妇幼保健中心合生元母婴营养与健康研究项目(2015FYH012)
关键词
婴儿
早产
发育障碍
纵向研究
Infant,premature
Developmental disabilities
Longitudinal study
