早产小于胎龄儿体格发育和神经心理发育研究  

Study on physical development and neuropsychological development of premature small for gestational age infants

作　　者：陈绍红[1] 何仕劼[1] 孟森玲 汪时华[1] 廖珠根[1] CHEN Shao-Hong;HE Shi-Jie;MENG Sen-Ling(Department of Child Health Care,Jiangxi Provincial Maternal and Child Health Care Hospital,Nanchartg,Jiangxi 330006,China)

机构地区：[1]江西省妇幼保健院儿童保健科

出　　处：《中国妇幼保健》2019年第23期5416-5419,共4页Maternal and Child Health Care of China

基　　金：中国疾控中心妇幼保健中心合生元母婴营养与健康项目(2016FYH012);江西省卫生计生委科技计划项目(20161114)

摘　　要：目的探讨早产小于胎龄儿(SGA)矫正12月龄内体格发育和神经心理发育。方法将出生并系统随访SGA31例(男17例,女14例)为SGA组,早产适于胎龄儿(AGA)101例(男56例,女45例)为对照(AGA组)。研究对象矫正6月龄内每月随访1次,6~12月龄内每2月随访1次,生长发育评价使用Z值(Z score)评价,对其0~12月内的体质量、身长及头围分别进行Z值评估并分析,计算年龄的身长Z值(LAZ)、年龄的体质量Z值(WAZ)、身长的体质量Z值(WLZ)和头围Z值(HCZ);分别于矫正6月龄和12月龄使用CDCC婴幼儿智能发育量表测试随访对象智力发育指数(MDI)和运动发育指数(PDI),并根据随访结果给予干预和指导。结果两组早产儿胎龄和男女构成比差异无统计学意义(P>0.05);SGA组矫正1~12月龄LAZ低于0,其中1~6月龄LAZ低于AGA组,两组差异有统计学意义(P<0.05),12月龄两组LAZ差异无统计学意义(P>0.05);SGA组矫正1~6月龄WAZ低于0,且低于AGA组,两组差异有统计学意义(P<0.05),早产SGA矫正12月龄WAZ追赶至0.47,SGA和AGA差异无统计学意义(P>0.05);SGA和AGA组WLZ仅在矫正1月龄差异有统计学意义(P<0.05),3月龄后二者差异无统计学意义(P>0.05);SGA组矫正1月龄和3月龄HCZ低于AGA组,二者间差异有统计学意义(P<0.05),而6月龄和12月龄差异无统计学意义(P>0.05)。早产SGA矫正6月龄MDI和PDI分别为92.9和91.0分,与AGA组差异无统计学意义(P>0.05);SGA矫正12月龄MDI和PDI分别为88.2和83.1分,与AGA组之间差异无统计学意义(P>0.05)。结论经早产儿系统保健的早产SGA婴儿早期体格发育落后于早产儿AGA,矫正12月龄追赶上AGA,早产SGA神经心理发育可与AGA一致。Objective To explore the physical development and neuropsychological development of premature small for gestational age(SGA)infants within the first 12 months of corrected age.Methods Thirty-one SGA infants(17 boys and 14 girls)were selected as SGA group,101 premature appropriate for gestational age(AGA)infants(56 boys and 45 girls)were selected as AGA group.Within the first6 months of corrected age,the infants were followed up once a month;within the first 6-12 months of corrected age,the infants were followed up twice a month.Z score was used to evaluate growth and development(weight,height,and head circumference).Z scores of length for age(LAZ),weight for age(WAZ),weight for length(WLZ),and head circumference(HCZ)were calculated.CDCC infant intelligent development scale was used to evaluate mental development index(MDI)and psychomotor development index(PDI)at 6 and 12 months of corrected age,intervention and guidance were provided according to the follow-up results.Results There was no statistically significant difference in fetal age and sex ratio between the two groups(P>0.05).LAZ at 12 months of corrected age in SGA group was less than 0,LAZ at 6 months of corrected age in SGA group was statistically significantly lower than that in AGA group(P<0.05),there was no statistically significant difference in LAZ at 12 months of corrected age between the two groups(P>0.05).WAZ at 6 months of corrected age in SGA group was less than 0,which was statistically significantly lower than that in AGA group(P<0.05).WAZ at 12 months of corrected age in SGA group catched up to 0.47,there was no statistically significant difference between the two groups(P>0.05).There was statistically significant difference in WLZ at 1 month of corrected age between the two groups(P<0.05),after 3 months of corrected age,there was no statistically significant difference between the two groups(P>0.05).At 1 and 3 months of corrected age,HCZs in SGA were statistically significantly lower than those in AGA(P<0.05),but there was no statistically

关 键 词：小于胎龄儿 适于胎龄儿 早产儿 体格发育 神经心理发育 

分 类 号：R72[医药卫生—儿科]