胎龄<32周极低/超低出生体重早产儿1岁时神经发育状况的随访研究  

Follow-up study on neurodevelopment at 1 year old of very/extremely low birth weight preterm infants with gestational age less than 32 weeks

作　　者：唐亮 袁伟明[1] 宋燕燕[1] 张婷[1] 梁晶晶 谭栩颖 Tang Liang;Yuan Weiming;Song Yanyan;Zhang Ting;Liang Jingjing;Tan Xuying(Department of Child Hygiene,Guangzhou Women and Children′s Medical Center Affiliated to Guangzhou Medical University,Guangzhou 510623,China)

机构地区：[1]广州医科大学附属广州市妇女儿童医疗中心儿童保健部,510623

出　　处：《中国小儿急救医学》2021年第11期946-950,共5页Chinese Pediatric Emergency Medicine

基　　金：广东省科技厅科技计划项目(2017A020214002)。

摘　　要：目的研究胎龄<32周的极低/超低出生体重早产儿矫正年龄1岁时神经发育状况。方法选择2015年1月至2018年12月在广州市妇女儿童医疗中心出生后收治新生儿科,并在出院后定期至高危儿门诊随访满1年的早产儿作为研究对象,按出生体重分为极低/超低出生体重组(出生体重<1500 g)、低出生体重组(1500 g≤出生体重<2500 g)、正常出生体重组(2500 g≤出生体重<4000 g)。比较三组早产儿矫正年龄1岁时神经发育状况及差异,并分析极低/超低出生体重儿的围生期高危因素对神经发育的影响。结果纳入研究的早产儿共270例,极低/超低出生体重组95例、低出生体重组124例、正常出生体重组51例。极低/超低出生体重组在矫正年龄1岁时适应性、大运动、精细运动、语言、个人社交和发育商均落后于其他两组,差异有统计学意义(P<0.05)。在95例患儿中,矫正年龄1岁时,神经发育异常发生率为42.1%(40/95);神经发育异常(发育商<85)者生后合并颅内出血的发生率高于神经发育正常者[85.0%(34/40)比29.1%(16/55),P<0.05]。结论极低/超低出生体重早产儿是1岁时神经发育异常的高危人群,生后颅内出血可能为神经发育异常的潜在高危因素,应重视围生期随访保健及早期干预,加强神经发育监测。Objective To study the neurodevelopmental status of very/extremely low birth weight preterm infants with gestational age less than 32 weeks at the corrected age of 1 year.Methods Preterm infants admitted to the Neonatology Department after birth at Guangzhou Women and Children′s Medical Center from January 2015 to December 2018 and followed up regularly to the high-risk infants clinic for at least 1 year after discharge were selected as the research subjects.According to the birth weight(BW),preterm infants were divided into very/extremely low birth weight group(BW<1500 g),low birth weight group(1500 g<BW<2500 g)and normal birth weight group(2500 g≤BW<4000 g).The neurodevelopment of preterm infants with different BW at the corrected age of 1 year were compared and the influence of perinatal risk factors on neurodevelopment of very/extremely low birth weight preterm infants were analyzed.Results A total of 270 preterm infants were included in the study,including 95 in the very/extremely low birth weight group,124 in the low birth weight group,and 51 in the normal birth weight group.At the corrected age of 1 year,adaptability,gross motor,fine motor,language,individual sociability and development quotient(DQ)in the very/extremely low birth weight group were lower than those in the other two groups(P<0.05).The incidence of neurodevelopmental abnormality(DQ<85)in very/extremely low birth weight preterm infants was 42.1%(40/95)at the corrected age of 1 year.The incidence of intracranial hemorrhage in neurodevelopmental abnormality group(85.0%,34/40)was higher than that in the control group(29.1%,16/55)(P<0.05).Conclusion Very/extremely low birth weight preterm infants are at high risk of neurodevelopmental abnormality at the age of 1 year,and intracranial hemorrhage may be a related potential risk factor.Perinatal follow-up care and early intervention should be emphasized to strengthen neurodevelopmental monitoring.

关 键 词：早产儿 极低/超低出生体重 神经发育 高危因素 随访 

分 类 号：R722.6[医药卫生—儿科]