小于胎龄与适于胎龄早产儿出院后体格生长和神经发育追赶状况  

Catch-up status of physical growth and neurodevelopment in preterm small for gestational age and appropriate for gestational age infants after discharge

作　　者：何雪雁 HE Xueyan(Department of Child Care,Ruichang Maternal and Child Health Hospital of Jiangxi Province,Ruichang,Jiangxi 332200,China)

机构地区：[1]江西省瑞昌市妇幼保健院儿保科,江西瑞昌332200

出　　处：《检验医学与临床》2023年第20期3009-3014,共6页Laboratory Medicine and Clinic

摘　　要：目的研究小于胎龄(SGA)与适于胎龄(AGA)早产儿出院后早期体格生长和神经发育追赶状况。方法选取2018年1月至2020年12月该院165例早产儿临床资料进行分析,根据出生体质量分为SGA组(56例)和AGA组(109例),另选取该院同期完成随访的足月适龄新生儿92例作为对照组,3组新生儿出院后定期进行门诊随访,定期测量身长、体质量和头围等指标,并计算Z评分和ΔZ评估体格生长情况。采用《0~6岁小儿神经心理发育诊断量表》计算发育商(DQ),评估神经发育情况,比较各组不同校正月龄体格生长和神经发育情况。结果3组新生儿身长、头围均变化均存在交互效应(P<0.001);校正1、3、6、9、12月龄时3组新生儿身长、体质量、头围均呈增长趋势,均存在时间效应(F_(时间)=5036.139、1198.241、2604.235,P<0.001);3组新生儿身长、体质量、头围变化均存在组间效应(P<0.001),SGA组新生儿身长、体质量、头围均低于AGA组和对照组,差异均有统计学意义(P<0.05)。3组新生儿身长、体质量、头围Z评分变化均存在交互效应(P<0.001);校正1、3、6、9、12月龄时3组新生儿身长、体质量、头围Z评分变化均存在时间效应(P<0.001);3组新生儿身长、体质量、头围Z评分均存在组间效应(P<0.001),SGA组新生儿身长、体质量、头围Z评分均明显低于AGA组和对照组,差异均有统计学意义(P<0.05)。校正1~3、>3~6、>6~9和>9~12月龄时3组新生儿身长、体质量、头围ΔZ评分变化存在时间效应(P<0.001);3组新生儿身长、体质量、头围ΔZ评分均存在组间效应(P<0.001);3组新生儿身长、体质量、头围ΔZ评分均存在交互效应(P<0.001)。SGA组校正1、3、6、9月龄时《0~6岁小儿神经心理发育诊断量表》的大运动、精细动作、认知功能、语言和社会行为DQ均明显低于AGA组和对照组,差异均有统计学意义(P<0.05);AGA组校正1、3、6月龄时大运动、精细动作、认知功能和�Objective To investigate the catch-up growth and neurodevelopment of preterm small for gestational age(SGA)and appropriate for gestational age(AGA)infants in the early stage after discharge.Methods The clinical data of 165 premature infants in this hospital from January 2018 to December 2020 were retrospectively analyzed.According to the birth weight,they were divided into SGA group(n=56)and AGA group(n=109),and 92 full-term infants in the same hospital were selected as control group.The 3 groups were followed up regularly after discharge,and the length,weight and head circumference were measured regularly.The developmental quotient(DQ)was calculated by the 0-6 years old Children′s Neuropsychological Development Diagnostic Scale to evaluate neurodevelopment,and the physical growth and neurodevelopment of each group at different corrected months were compared.Results There was an interaction effect on body length and head circumference among the 3 groups(P<0.001).After adjusting for the age of 1,3,6,9,and 12 months,the length,weight,and head circumference of the 3 groups showed an increasing trend,and there were time effects(F_(time)=5036.139,1198.241,2604.235,P<0.001).There were inter-group effects in the changes of neonatal length,weight,and head circumference among the 3 groups(P<0.001).The neonatal length,weight,and head circumference in SGA group were lower than those in AGA group and control group,and the differences were statistically significant(P<0.05).There were interaction effects in the changes of Z scores of neonatal length,weight,and head circumference among the 3 groups(P<0.001).At the corrected age of 1,3,6,9,and 12 months,there were time effects on the Z scores of neonatal length,weight,and head circumference among the 3 groups(P<0.001).There were inter-group effects in the Z scores of length,weight,and head circumference among the 3 groups(P<0.001).The Z scores of length,weight,and head circumference in SGA group were significantly lower than those in AGA group and control group,and the differe

关 键 词：早产儿 小于胎龄儿 适于胎龄儿 体格生长 神经发育 追赶生长 

分 类 号：R722.6[医药卫生—儿科]