早发型重度子痫前期孕妇分娩早产儿3~4岁时体格发育及行为问题的回顾性研究

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目的比较早发型重度子痫前期(early on-set severe preeclampsia,ES-PE)孕妇与相应孕周非子痫前期孕妇分娩早产儿3~4岁时体格发育和行为问题的差异。方法选择2011年10月-2012年11月中国医科大学附属盛京医院产科收治的ES-PE孕妇分娩的74例早产儿为观察组;同期住院相应孕周非子痫前期孕妇分娩的80例早产儿为对照组,比较两组早产儿出生时的一般情况。通过电话随访方式,依照Conners父母症状问卷(Parents Symptom Questionnaire,PSQ)对两组早产儿3~4岁时的体格发育和行为问题情况进行评估。结果出生时,观察组早产儿身长及体质量均明显低于对照组(P<0.05);随访时,体格发育方面,仅在出生孕周<32周、出生体质量<1 500 g的亚组中,观察组早产儿的体质指数(BMI)明显低于对照组(P<0.05),其余各亚组比较,差异均无统计学意义(P>0.05)。随访时,孕周<32周、出生体质量≥1 500 g亚组中对照组多动评分明显高于观察组(P<0.05),孕周≥32周、出生体质量≥1 500 g的亚组观察组焦虑评分明显高于对照组(P<0.05),其余各行为学项目评分比较,差异均无统计学意义(均P>0.05)。结论 ES-PE对早产儿的发育有一定影响,但是影响有限。加强围产保健、降低ES-PE发生、延长ES-PE患者孕周对于改善ES-PE胎儿预后有意义。 Objective To compare the difference between physical development and behavior problems of preterm infants born 3 to 4 years old in early-onset severe preeclampsia (ES-PE) and corresponding gestational weeks of non-preeclampsia. Methods Seventy-four preterm infants delivered by ES-PE maternity department of Shengjing Hospital Affiliated to China Medical University from October 2011 to November 2012 were selected as the observation group. 80 preterm infants delivered in pregnant women with non-pre-eclampsia during the corresponding period of gestation were Control group, comparing the two groups of premature children born at the general situation. By telephone follow-up, physical development and behavioral problems at 3 to 4 years of age were assessed in both groups according to the Conners Parents Symptom Questionnaire (PSQ). Results At birth, the body length and body weight of the preterm infants in the observation group were significantly lower than those in the control group (P <0.05). At the follow-up, in the physical development, only the gestational age <32 weeks and the birth weight <1500 g The body mass index (BMI) in the observation group was significantly lower than that in the control group (P <0.05). There was no significant difference in other subgroups (P> 0.05). At follow-up, the gestational age <32 weeks, the birth weight ≥ 1500 g subgroup control group was significantly higher than the observation group (P <0.05), gestational age ≥ 32 weeks, birth weight ≥ 1500 g The scores of anxiety in the observation group were significantly higher than those in the control group (P <0.05). There was no significant difference in scores of the other behavioral items between the two groups (all P> 0.05). Conclusion ES-PE has a certain impact on the development of premature children, but the impact is limited. Strengthening perinatal care, reducing the occurrence of ES-PE and prolonging the gestational age of ES-PE patients are of significance for improving the prognosis of ES-PE fetuses.
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