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目的探讨晚期早产儿在校正年龄1岁时的神经发育情况及其影响因素。方法采用首都儿科研究所修订的《0～6岁小儿神经心理发育量表》,对2008年4月至2009年4月于本院产科分娩的晚期早产儿及足月儿在校正年龄/生后年龄满1岁时进行智能发育测试,按照发育商(DQ)将晚期早产儿分为神经行为发育异常组(DQ<85)和正常组(DQ≥85),分析可能对神经发育产生影响的社会家庭因素和临床相关因素,应用Logistic回归分析筛选影响晚期早产儿神经发育的危险因素。结果晚期早产儿组165例,校正年龄1岁时神经行为发育异常9例(5.5%),对照组102例,1岁时神经行为发育异常3例(2.9%),两组差异有统计学意义(χ2=5.047,P<0.05)。1岁时晚期早产儿DQ低于足月儿[(93.8±7.5)分比(98.8±9.8)分,P<0.05],其大运动、精细动作、语言均落后于足月儿。极低出生体重(OR=2.175)、低血糖(OR=1.924)、母亲文化程度初中以下(OR=0.602)是影响晚期早产儿神经发育预后的危险因素(P<0.05)。结论晚期早产儿是发生不良神经预后的高危人群,与极低出生体重、低血糖、母亲文化水平低密切相关。
Objective To investigate the neurodevelopment and its influencing factors in late preterm infants with corrected age of 1 year. Methods The “Pediatric Neuropsychological Developmental Scale 0- to 6-year-old” as revised by Capital Institute of Pediatrics was used to evaluate the relationship between the corrected age / postnatal period in late preterm infants and full-term infants in obstetric delivery in our hospital from April 2008 to April 2009 At 1 year of age, intelligent developmental tests were conducted, and late-stage preterm infants were divided into neurobehavioral abnormalities group (DQ <85) and normal group (DQ≥85) according to DQ, to analyze the possible impact on neurodevelopment Family factors and clinically relevant factors, Logistic regression analysis was used to screen for the risk factors affecting the neurodevelopment of late preterm children. Results There were 165 cases of advanced preterm children, 9 cases (5.5%) had abnormal neurobehavioral development at the age of 1 year, 102 cases in the control group, and 3 cases (2.9%) had abnormal neurobehavioral development at the age of 1 years. There was significant difference between the two groups (χ2 = 5.047, P <0.05). At 1 year of age, DQ in late stage preterm infants was lower than that in term infants [(93.8 ± 7.5) points (98.8 ± 9.8) points, P <0.05]. The large movement, fine movement and language lagged the term children. Very low birth weight (OR = 2.175), hypoglycemia (OR = 1.924), lower maternal education level (OR = 0.602) were the risk factors for the prognosis of advanced preterm infants (P <0.05). Conclusions The late preterm infant is a high risk group with adverse neurological prognosis, which is closely related to the low birth weight, hypoglycemia and low level of mother’s education.