高危因素对早产儿发育的影响及其干预效果  

The impact of high risk factors on development of preterm infant and effect of intervention

作　　者：章恒[1] 卫雅蓉[1] 蒋新液[1] 李怡[2] 

机构地区：[1]无锡市妇幼保健院儿童保健科,214000 [2]无锡市妇幼保健院新生儿科,214000

出　　处：《中国新生儿科杂志》2014年第6期365-369,共5页Chinese Journal of Neonatology

基　　金：无锡市医管中心面上项目基金(YGM1115);南京医科大学基金面上项目(NJMU056)

摘　　要：目的探讨高危因素对早产儿营养、智能、神经发育的影响及干预效果。方法选择2008年1～12月在我院出生并定期在儿童保健科进行体格检查的早产儿,根据是否伴有高危因素（超早产、极低出生体重、脑损伤、高胆红素血症、重度窒息）分为高危因素组和非高危因素组。高危因素组再根据家长干预依从性分成干预组和非干预组,同时匹配本院足月分娩的健康婴幼儿为足月儿组。比较不同组别校正年龄2岁时的营养、智能和神经发育结局以及干预效果。结果完成随访早产儿372例,其中非高危因素组223例,高危因素组149例（干预组71例,非干预组78例）,足月儿组231例。不同组别婴幼儿性别、分娩方式、家庭经济水平,以及干预组与非干预组基础疾病差异均无统计学意义（P〉0.05）。校正年龄2岁时,高危因素组贫血和维生素D缺乏发生率高于非高危因素组（15.4%比6.7%,19.5%比11.2%）,非干预组高于干预组（23.1%比7.0%,25.6%比12.7%）,早产儿组、高危因素组和非干预组发育商（DQ,分）均低于相应的足月儿组、非高危因素组和干预组[（85.2±11.4）比（98.3±5.3）,（79.5±13.4）比（89.0±7.8）,（71.2±10.9）比（88.6±9.4）],智能低下和脑性瘫痪发生率均高于相对应的足月儿组、非高危因素组和干预组（智能低下：7.0%比0.4%,16.8%比0.5%,30.8%比1.4%,脑性瘫痪：3.0%比0.4%,6.0%比0.9%,10.3%比1.4%）,差异均有统计学意义（P〈0.05）。结论 2岁内早产儿发育落后于足月儿,高危因素增加早产儿营养不良、DQ低下和脑性瘫痪的风险,而干预能一定程度改善早产儿发育。Objective To investigate the impact of high risk factors on the development of preterm infants and the effect of intervention.Methods Premature infants who were born in our hospital were divided into high risk factors（HRF） group and non high risk factors（ NHRF） group according to whether they were accompanied by risk factors（extremely prematurity,low birth weight,brain damage,severe asphyxia,hyperbilirubinemia） or not.HRF group was divided into intervention group and nonintervention group based on intervention compliance of their parents.Normal infants were matched as a full-term group at the same time.Comparison was made of nutritional status, intelligence and neurodevelopment at 2 years corrected age among the different goups and the effect of intervention.Results A total of 372 cases of preterm infant follow-up were completed,including 223 cases of NHRF group,149 cases of the HRF group（71 cases of intervention group,78 cases of non-intervention group）,and 231 cases of full-term infant.There were no differences in sex,mode of delivery,family economic level among the different groups,as well as underlying disease between the intervention and nonintervention group（ P〉0.05）.For 2 years corrected age,the incidences of anemia and vitamin D deficiency in HRF group were much higher than those in NHRF group respectively（15.4% vs.6.7%,19.5% vs.11.2%）.The developmental quotient（DQ,scores） in the,preterm group,HRF group and non-intervention group were correspondingly much lower than those in full-term group,NHRF and intervention group [（85.2 ± 11.4） vs.（98.3 ± 5.3）,（79.5 ± 13.4） vs.（89.0 ± 7.8）,（71.2 ± 10.9）vs.（88.6 ± 9.4）],while the incidences of mental retardation and cerebral palsy were correspondingly much higher than those in full-term group,NHRF and intervention group [（mental retardation 7.0% vs.0.4%,16.8% vs.0.5%,30.8% vs.1.4%）,（ cerebral palsy 3.0% vs.0.4%,6.0% vs.0.9%,10.3% vs.1.4%）]（ P〈0.05）.Conclusions The development of preterm infants

关 键 词：婴儿 早产 贫血 维生素D缺乏 脑性瘫痪 干预性研究 

分 类 号：R174.1[医药卫生—妇幼卫生保健]