大于胎龄儿12月龄神经心理发育状况研究

doi:10.7499/j.issn.1008-8830.2307040

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摘要目的探讨大于胎龄儿（large for gestational age, LGA）12月龄时神经心理发育水平。方法选择2021年12月—2023年6月在山东第一医科大学第一附属医院儿童保健门诊就诊的12~<13月龄儿童为研究对象，按胎龄及出生体重分为早产适于胎龄儿（appropriate for gestational age, AGA）、早产LGA、早期足月AGA、早期足月LGA、完全足月AGA和完全足月LGA 6组，使用修正Poisson回归分析LGA与12月龄时神经心理发育结局的关系。结果校正混杂因素后，与完全足月AGA相比，完全足月LGA 12月龄时语言发育异常的风险明显增加（RR=1.364，95%CI：1.063~1.750）；早期足月LGA 12月龄时粗大运动、精细运动、语言，以及早产LGA 12月龄时语言、社会行为发育异常及总发育商异常的风险增加（P<0.05）；早期足月AGA 12月龄时5大能区发育异常及总发育商异常的风险增加（P<0.05）；除语言能区外，早产AGA 12月龄时其余4大能区发育异常的风险增加（P<0.05）。结论不同胎龄LGA在12月龄时神经心理发育均落后于完全足月AGA，临床应重视其随访并早期干预。

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	包梦雨
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	陈新霞

关键词 ：大于胎龄儿, 神经心理发育, 早产儿, 早期足月儿, 完全足月儿

Abstract：Objective To investigate the level of neuropsychological development in large for gestational age (LGA) infants at the age of 12 months. Methods The infants, aged 12 to <13 months, who attended the Outpatient Service of Child Care in the First Affiliated Hospital of Shandong First Medical University from December 2021 to June 2023, were enrolled as subjects. According to the gestational age and birth weight, they were divided into preterm appropriate for gestational age (AGA) group, preterm LGA group, early term AGA group, early term LGA group, full-term AGA group, and full-term LGA group. A modified Poisson regression analysis was used to investigate the association between LGA and neuropsychological development outcome at 12 months of age. Results After adjustment for confounding factors, compared with the full-term AGA group at the age of 12 months, the full-term LGA group had a significant increase in the risk of language deficit (RR=1.364, 95%CI: 1.063-1.750), the early term LGA group had significant increases in the risk of abnormal gross motor, fine motor, language, and the preterm LGA group had significant increases in the risk of abnormal language, social behavior, and total developmental quotient (P<0.05); also, the early term AGA group had higher risks of developmental delay across all five attributes and in total developmental quotient at the age of 12 months (P<0.05); except for the language attribute, the preterm AGA group had higher risks of developmental delay in the other 4 attributes (P<0.05). Conclusions The neuropsychological development of LGA infants with different gestational ages lags behind that of full-term AGA infants at 12 months of age, and follow-up and early intervention of such infants should be taken seriously in clinical practice.

Key words： Large for gestational age infant Neuropsychological development Preterm infant Early term infant Full-term infant

收稿日期: 2023-07-13

通讯作者: 陈新霞，女，副教授。Email：chenxxsdu@163.com。 E-mail: chenxxsdu@163.com

作者简介: 包梦雨，女，硕士研究生；

引用本文:

包梦雨,乔秀芸,张新涵等. 大于胎龄儿12月龄神经心理发育状况研究[J]. 中国当代儿科杂志, 2023, 25(12): 1246-1252.

BAO Meng-Yu,QIAO Xiu-Yun,ZHANG Xin-Han et al. Neuropsychological development of large for gestational age infants at the age of 12 months[J]. CJCP, 2023, 25(12): 1246-1252.

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	Zhao Y, Li DZ. Born large for gestational age: not just bigger[J]. Am J Obstet Gynecol, 2023, 228(3): 366-367. PMID: 36402200. DOI: 10.1016/j.ajog.2022.11.1285.
	Chiavaroli V, Derraik JG, Hofman PL, et al. Born large for gestational age: bigger is not always better[J]. J Pediatr, 2016, 170: 307-311. PMID: 26707580. DOI: 10.1016/j.jpeds.2015.11.043.
	Khambalia AZ, Algert CS, Bowen JR, et al. Long-term outcomes for large for gestational age infants born at term[J]. J Paediatr Child Health, 2017, 53(9): 876-881. PMID: 28868781. DOI: 10.1111/jpc.13593.
	Boghossian NS, Geraci M, Edwards EM, et al. In-hospital outcomes in large for gestational age infants at 22-29 weeks of gestation[J]. J Pediatr, 2018, 198: 174-180.e13. PMID: 29631772. DOI: 10.1016/j.jpeds.2018.02.042.
	Yang F, Janszky I, Gissler M, et al. Preterm birth, small for gestational age, and large for gestational age and the risk of atrial fibrillation up to middle age[J]. JAMA Pediatr, 2023, 177(6): 599-607. PMID: 37093612. PMCID: PMC10126943. DOI: 10.1001/jamapediatrics.2023.0083.
	Wang X, Liang L, Junfen FU, et al. Metabolic syndrome in obese children born large for gestational age[J]. Indian J Pediatr, 2007, 74(6): 561-565. PMID: 17595499 DOI: 10.1007/s12098-007-0108-9.
	Moore GS, Kneitel AW, Walker CK, et al. Autism risk in small- and large-for-gestational-age infants[J]. Am J Obstet Gynecol, 2012, 206(4): 314.e1-314.e9. PMID: 22464070. PMCID: PMC9884028. DOI: 10.1016/j.ajog.2012.01.044.
	Hong YH, Lee JE. Large for gestational age and obesity-related comorbidities[J]. J Obes Metab Syndr, 2021, 30(2): 124-131. PMID: 34053939. PMCID: PMC8277589. DOI: 10.7570/jomes20130.
	9 刘宇, 杨新军. 异常出生体重与儿童青少年神经行为发育的研究进展[J]. 中国儿童保健杂志, 2022, 30(7): 759-763. DOI: 10.11852/zgetbjzz2021-1075.
	10 胡月, 鲍筝, 侯月云, 等. 2017-2021年北京市通州区0～2岁儿童神经心理的发育现状和变化趋势[J]. 上海预防医学, 2023, 35(5): 488-493. DOI: 10.19428/j.cnki.sjpm.2023.22570.
	Rustogi D, Synnes A, Alshaikh B, et al. Neurodevelopmental outcomes of singleton large for gestational age infants <29 weeks' gestation: a retrospective cohort study[J]. J Perinatol, 2021, 41(6): 1313-1321. PMID: 34035448. DOI: 10.1038/s41372-021-01080-z.
	12 Costantine MM, Tita ATN, Mele L, et al. The association between infant birth weight, head circumference, and neurodevelopmental outcomes[J]. Am J Perinatol, 2023. PMID: 36791785. PMCID: PMC10425571. DOI: 10.1055/s-0043-1761920. Epub ahead of print.
	Jee G, Kotecha SJ, Chakraborty M, et al. Early childhood parent-reported speech problems in small and large for gestational age term-born and preterm-born infants: a cohort study[J]. BMJ Open, 2023, 13(4): e065587. PMID: 37105706. PMCID: PMC10151836. DOI: 10.1136/bmjopen-2022-065587.
	Tamai K, Yorifuji T, Takeuchi A, et al. Associations of birth weight for gestational age with child health and neurodevelopment among term infants: a nationwide Japanese population-based study[J]. J Pediatr, 2020, 226: 135-141.e4. PMID: 32640270. DOI: 10.1016/j.jpeds.2020.06.075.
	梁晶晶, 胡艳, 邢艳菲, 等. 晚期早产儿和早期足月儿1岁时神经心理发育水平的随访研究[J]. 中国当代儿科杂志, 2020, 22(7): 706-710. PMID: 32669165. PMCID: PMC7389612. DOI: 10.7499/j.issn.1008-8830.1912132.
	16 金春华, 李瑞莉, 张丽丽, 等. 《中国儿童发育量表》修订及效度研究[J]. 中国儿童保健杂志, 2014, 22(12): 1242-1246. DOI: 10.11852/zgetbjzz2014-22-12-04.
	首都儿科研究所, 九市儿童体格发育调查协作组. 中国不同出生胎龄新生儿出生体重、身长和头围的生长参照标准及曲线[J]. 中华儿科杂志, 2020, 58(9): 738-746. PMID: 32872714. DOI: 10.3760/cma.j.cn112140-20200316-00242.
	18 鲍玲, 任军爽, 王蕊. 6月龄婴儿神经心理发育现状及相关危险因素分析[J]. 首都医科大学学报, 2021, 42(2): 334-337. DOI: 10.3969/j.issn.1006-7795.2021.02.029.
	Adanikin A, Lawlor DA, Pell JP, et al. Association of birthweight centiles and early childhood development of singleton infants born from 37 weeks of gestation in Scotland: a population-based cohort study[J]. PLoS Med, 2022, 19(10): e1004108. PMID: 36219591. PMCID: PMC9553050. DOI: 10.1371/journal.pmed.1004108.
	20 高红琼, 曹月婷, 方红英, 等. 铜陵市婴幼儿语言发育现状及影响因素分析[J]. 现代预防医学, 2023, 50(4): 649-653. DOI: 10.20043/j.cnki.MPM.202205460.
	21 刘慧燕, 陈蓁蓁, 陈小霞, 等. 儿童早期语言发育迟缓的影响因素分析[J]. 中国儿童保健杂志, 2019, 27(12): 1285-1287. DOI: 10.11852/zgetbjzz2019-0244.
	22 刘慧燕, 宋燕燕, 张舒琴, 等. 语言发育迟缓儿童的行为及语言特征分析[J]. 中国儿童保健杂志, 2023, 31(4): 365-368. DOI: 10.11852/zgetbjzz2022-0682.
	23 罗茜, 崔丽君, 李芋均. 儿童语言发育迟缓影响因素的研究进展[J]. 当代护士（下旬刊）, 2022, 29(11): 10-12. DOI: 10.19793/j.cnki.1006-6411.2022.33.003.
	Ribas-Prats T, Arenillas-Alcón S, Pérez-Cruz M, et al. Speech-encoding deficits in neonates born large-for-gestational age as revealed with the envelope frequency-following response[J]. Ear Hear, 2023, 44(4): 829-841. PMID: 36759954. DOI: 10.1097/AUD.0000000000001330.
	25 郭建华, 段晓辉, 胡新生. 巨大儿体格与神经精神发育调查分析[J]. 中国儿童保健杂志, 2001, 9(1): 58-59. DOI: 10.3969/j.issn.1008-6579.2001.01.033.
	Hua J, Barnett AL, Lin Y, et al. Association of gestational age at birth with subsequent neurodevelopment in early childhood: a national retrospective cohort study in China[J]. Front Pediatr, 2022, 10: 860192. PMID: 35712637. PMCID: PMC9194570. DOI: 10.3389/fped.2022.860192.
	27 唐亮, 梁晶晶, 宋燕燕. 1 042名儿童2岁时神经心理发育状况的随访研究[J]. 中国儿童保健杂志, 2022, 30(6): 599-602. DOI: 10.11852/zgetbjzz2021-0866.
	Guillot M, Sebastianski M, Lemyre B. Comparative performance of head ultrasound and MRI in detecting preterm brain injury and predicting outcomes: a systematic review[J]. Acta Paediatr, 2021, 110(5): 1425-1432. PMID: 33206399. DOI: 10.1111/apa.15670.
	Chawanpaiboon S, Vogel JP, Moller AB, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis[J]. Lancet Glob Health, 2019, 7(1): e37-e46. PMID: 30389451. PMCID: PMC6293055. DOI: 10.1016/S2214-109X(18)30451-0.
	Xia Y, Xiao J, Yu Y, et al. Rates of neuropsychiatric disorders and gestational age at birth in a Danish population[J]. JAMA Netw Open, 2021, 4(6): e2114913. PMID: 34185070. PMCID: PMC8243234. DOI: 10.1001/jamanetworkopen.2021.14913.
	31 张嘉佳, 王磊, 陈桂霞, 等. 中国六城市46 073例早期儿发育性协调障碍的调查[J]. 中国儿童保健杂志, 2021, 29(12): 1291-1294, 1299. DOI: 10.11852/zgetbjzz2021-0080.
	Pierrat V, Marchand-Martin L, Marret S, et al. Neurodevelopmental outcomes at age 5 among children born preterm: EPIPAGE-2 cohort study[J]. BMJ, 2021, 373: n741. PMID: 33910920. PMCID: PMC8080137. DOI: 10.1136/bmj.n741.
	Stewart DL, Barfield WD, Committee on Fetus and Newborn. Updates on an at-risk population: late-preterm and early-term infants[J]. Pediatrics, 2019, 144(5): e20192760. PMID: 31636141. DOI: 10.1542/peds.2019-2760.