摘要
目的以新生儿重症监护病房内极低出生体质量儿的不同头围增长速度预测纠正满1岁时的神经运动发育结局。方法前瞻性收集2016年6月至2017年12月入住新生儿重症监护病房的极低出生体质量(出生体质量<1 500 g)早产儿,动态监测住院期间头围增长速度,按不同头围增长速度百分位数分为缓慢增长组(增长速度<P10)、中度增长组(增长速度P10~P90)和快速增长组(增长速度>P90)。持续随访至纠正满1岁,运用贝利婴幼儿发育量表评估神经运动发育,分为发育迟缓(≤69分)、临界(70~79分)和正常(≥80分)组,比较各组体格发育及并发症情况。结果 131例研究对象,平均胎龄(30.29±2.06)周,平均出生体质量(1 280±184)g,住院期间头围增长平均速度为(0.49±0.19)cm/周。缓慢增长组、中度增长组和快速增长组的头围增长速度分别为(0.12±0.05)cm/周、(0.49±0.13)cm/周和(0.81±0.03)cm/周;中度增长组和快速增长组的纠正1岁龄的智力发育指数(MDI)和运动发育指数(PDI)均高于缓慢增长组,差异有统计学意义(P<0.05)。MDI临界组和正常组的头围增长速度均大于发育迟缓组,PDI正常组的头围增长速度大于发育迟缓组,差异均有统计学意义(P<0.05)。结论极低出生体质量儿住院期间头围增长速度与纠正满1岁时的神经运动发育结局具有相关性。
Objective To predict the neuromotor development outcome at the corrected age of 1 year by the head circumference growth rate of very low birth weight(VLBW)infants in the neonatal intensive care unit(NICU).Methods The VLBW preterm infants(birth weight<1500 g)admitted to NICU from June 2016 to December 2017 were prospectively collected.The growth rate of head circumference during hospitalization was monitored dynamically.According to the percentiles of different growth rates of head circumference,they were divided into slow growth group,moderate growth group and rapid growth group.The follow-up was continued until the corrected age of 1 year.The neuromotor development was assessed by the Bayley scales of infant development.According to the score results,the children were divided into the developmental retardation group(≤69 points),marginal group(70-79 points)and normal group(≥80 points),and the anthropometrics and complications among three group were compared.Results The mean gestational age of the 131 subjects was(30.29±2.06)weeks,the mean birth weight was(1280±184)g,and the average growth rate of head circumference during hospitalization was(0.49±0.19)cm/week.The head circumference growth rates of slow growth,moderate growth group and rapid growth group were(0.12±0.05)cm/week,(0.49±0.13)cm/week and(0.81±0.03)cm/week respectively.The corrected 1-year-old mental development index(MDI)and physical development index(PDI)in moderate growth group and rapid growth group were higher than those in slow growth group,and the difference was statistically significant(P<0.05).The growth rate of head circumference in both the MDI marginal group and the normal group was greater than that in the development retardation group,and the growth rate of head circumference in the PDI normal group was greater than that in the development retardation group,and differences statistically significant(P<0.05).Conclusions The growth rate of head circumference of VLBW infants during hospitalization was correlated with the neuromotor d
作者
章晓婷
赵祥群
李明英
钟晓云
ZHANG Xiaoting;ZHAO Xiangqun;LI Mingying;ZHONG Xiaoyun(Chongqing Health Center for Women and Children,Chongqing 401120,China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2020年第4期241-245,共5页
Journal of Clinical Pediatrics
基金
重庆市科学技术委员会自然科学基金项目(No.cstc2018jcyjAX0332)
重庆市卫生健康委员会医学科研项目(No.2017MSXM109)。
关键词
头围
神经运动发育
极低出生体质量儿
very low birth weight infant
head circumference
neuromotor development
