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早产儿矫正年龄1岁时神经发育特征分析
Neurodevelopmental features of preterm infants at the corrected age of 1 year
目的 分析早产儿1岁时神经发育水平及并发症所致的影响，为改善神经发育预后提供资料。方法 以住院治疗早产儿为研究对象，采集出生胎龄、出生体重与并发症等资料，应用Bayley婴幼儿发展量表评估神经发育水平。早产儿按胎龄、出生体重及有无某种并发症分组，统计各组智力发展指数 （MDI）、精神运动发展指数 （PDI）及神经发育等级构成。结果 矫正年龄1岁时，早期早产儿组MDI、PDI均数均显著低于晚期早产儿组 （P < 0.05），智力、精神运动发育迟滞率均显著高于晚期早产儿组 （P < 0.01）。低出生体重儿组MDI、PDI均数均显著低于正常出生体重儿组 （P < 0.01），智力、精神运动发育迟滞率均显著高于正常出生体重儿组 （P < 0.01）。有高胆红素血症、出生窒息、呼吸窘迫综合征 （NRDS）早产儿MDI、PDI均数分别显著低于无此类并发症者 （P < 0.05）。结论 胎龄越小、出生体重越低的早产儿智力和运动发育水平越差、发育迟滞率越高。引起早产儿神经发育损害的主要并发症可能是高胆红素血症、出生窒息和NRDS。
Objective To investigate the neurodevelopmental level of preterm infants at the corrected age of 1 year and the effect of complications on neurodevelopment. Methods The clinical data and follow-up data of hospitalized preterm infants were retrospectively studied. The Bayley Scales of Infant Development was used to assess the neurodevelopmental level. Preterm infants were divided into groups according to gestational age, birth weight, and the presence or absence of complications. The mental development index (MDI) and psychomotor development index (PDI) were compared between groups. Results At the corrected age of 1 year, compared with the late preterm infants, the early preterm infants had significantly lower MDI and PDI (P < 0.05) and significantly higher rates of retarded intellectual and psychomotor development (P < 0.01). Compared with the normal birth weight group, the low birth weight group had significantly lower MDI and PDI (P < 0.01) and significantly higher rates of retarded intellectual and psychomotor development (P < 0.01). The preterm infants with hyperbilirubinemia, birth asphyxia or neonatal respiratory distress syndrome (NRDS) had significantly lower MDI and PDI than those without such complications (P < 0.05). Conclusions Lower gestational age and birth weight are associated with worse intellectual and psychomotor development in preterm infants. Complications, such as hyperbilirubinemia, birth asphyxia and NRDS, have adverse effects on neurodevelopment of preterm infants.
Neurodevelopment / Bayley Scales of Infant Development / Complication / Preterm infant
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湖南省科技厅科研课题（2013FJ3065）。
