宫内发育迟缓早产儿生后生长迟缓对早期神经发育的影响  

Effects of postnatal growth retardation on early neurodevelopment in premature infants with intrauterine growth retardation

作　　者：蔡岳鞠[1] 宋燕燕[1] 黄志坚[1] 李坚[1] 齐俊冶 肖旭文 王兰秀[1] 

机构地区：[1]广州医科大学附属广州市妇女儿童医疗中心新生儿科,广东广州510623

出　　处：《中国当代儿科杂志》2015年第9期893-897,共5页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨宫内发育迟缓(IUGR)早产儿生后生长迟缓对早期神经发育的影响。方法回顾性分析2008年5月至2012年5月出生并定期随访至校正胎龄6个月的171例早产儿的临床资料,其中IUGR早产儿40例,早产适于胎龄儿(AGA)131例。比较两组校正胎龄40周、3个月、6个月的生长迟缓率及校正胎龄3个月、6个月时的神经发育情况。神经发育采用Gesell发育量表评估。结果 IUGR组校正胎龄40周、3个月、6个月的生长迟缓率均明显高于AGA组;校正胎龄3个月时Gesell各项发育商(大运动、精细动作、语言、适应性及个人社交)均低于AGA组;校正胎龄6个月时,IUGR组精细动作及语言发育商低于AGA组,但两组大运动、适应性及个人社交发育商比较差异已无统计学意义。IUGR组6月龄时体重追赶落后的患儿各项发育商均明显低于追赶理想的IUGR和AGA患儿。结论 IUGR早产儿生后早期的生长迟缓可对早期神经发育产生不良影响。Objective To study the effects of postnatal growth retardation on early neurodevelopment in premature infants with intrauterine growth retardation （IUGR）. Methods A retrospective analysis was performed on the clinical data of 171 premature infants who were born between May 2008 and May 2012 and were followed up until a corrected gestational age of 6 months. These infants were classified into two groups： IUGR group （n=40） and appropriate for gestational age （AGA） group （n=131）. The growth retardation rates at the corrected gestational ages of 40 weeks, 3 months, and 6 months, as well as the neurodevelopmental outcome （evaluated by Gesell Developmental Scale） at corrected gestational ages of 3 and 6 months, were compared between the two groups. Results The growth retardation rate in the IUGR group was signiifcantly higher than in the AGA group at the corrected gestational ages of 40 weeks, 3 months, and 6 months. All ifve developmental quotients evaluated by Gesell Developmental Scale （gross motor, ifne motor, language, adaptability and individuality） in the IUGR group were signiifcantly lower than in the AGA group at the corrected gestational ages of 3 months. At the corrected gestational age of 6 months, the developmental quotients of ifne motor and language in the IUGR group were signiifcantly lower than in the AGA group, however, there were no signiifcant differences in the developmental quotients of gross motor, adaptability and individuality between the two groups. All five developmental quotients in IUGR infants with catch-up lag in weight were significantly lower than in IUGR and AGA infants who had caught up well. Conclusions Growth retardation at early postnatal stages may adversely affect the early neurodevelopment in infants with IUGR.

关 键 词：宫内发育迟缓 追赶性生长 神经发育 早产儿 

分 类 号：R722.6[医药卫生—儿科]