
Effect of oral motor intervention in improving brain function development in preterm infants: a randomized controlled trial
ZHANG Rong, CHEN Yu, ZHANG Lian-Yu, WANG Yu, DONG Wen-Bin
Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (5) : 475-481.
Effect of oral motor intervention in improving brain function development in preterm infants: a randomized controlled trial
Objective To study the effect of oral motor intervention (OMI) on brain function development in preterm infants. Methods A total of 112 preterm infants were stratified into small-gestational-age (30-31+6 weeks) and large-gestational-age (32-33+6 weeks) according to gestational age at birth. The preterm infants were randomly divided into a control group and an intervention group, with 56 infants in each group. The infants in the control group were given routine treatment and nursing, while those in the intervention group were given OMI in addition to the treatment and nursing in the control group. Amplitude-integrated EEG (aEEG) and Neonatal Behavioral Neurological Assessment (NBNA) were performed on days 1, 7, and 14 of enrollment, and the level of brain function development was compared before and after intervention. Results On day 7 of OMI, the small-gestational-age intervention group had lower upper bounds of voltage and bandwidth and a higher aEEG score than the small-gestational-age control group (P < 0.05). Compared with the small-gestational-age control group, the small-gestational-age intervention group had higher upper bound of voltage, percentage of mature sleep-wake cycle, aEEG score, and NBNA score and a lower narrow bandwidth on day 14 of OMI (P < 0.05). Compared with the large-gestational-age control group, the large-gestational-age intervention group had lower upper voltage and voltage difference and higher lower bound of voltage and aEEG score on days 7 and 14 of OMI (P < 0.05). On day 7 of OMI, the large-gestational-age intervention group had a higher NBNA score than the large-gestational-age control group (P < 0.05). Conclusions OMI can promote the maturation of aEEG background activities, improve neurobehavioral manifestations, and accelerate brain function development in preterm infants.
Oral motor intervention / Amplitude-integrated electroencephalogram / Neurodevelopment / Neurobehavioral scale / Preterm infant
[1] 曾丽香. 二孩政策放开后早产儿发生率及其结局的调查分析[J]. 湘南学院学报(医学版), 2017, 19(4):53-55.
[2] Adams-Chapman I, Heyne RJ, DeMauro SB, et al. Neurodevelopmental impairment among extremely preterm infants in the neonatal research network[J]. Pediatrics, 2018, 141(5):e20173091.
[3] Chang JH, Hsu CH, Tsou KI, et al. Outcomes and related factors in a cohort of infants born in Taiwan over a period of five years (2007-2011) with borderline viability[J]. J Formos Med Assoc, 2018, 117(5):365-373.
[4] Andrade E, Araujo Júnior E, Rolo LC, et al. Risk factors for cerebral palsy in premature infants identified during the pre and perinatal periods:a case-control study[J]. Minerva Ginecol, 2016, 68(1):29-36.
[5] Zeraati H, Nasimi F, Rezaeian A, et al. Effect of multi-sensory stimulation on neuromuscular development of premature infants:a randomized clinical trial[J]. Iran J Child Neurol, 2018, 12(3):32-39.
[6] Li XL, Liu Y, Liu M, et al. Early premature infant oral motor intervention improved oral feeding and prognosis by promoting neurodevelopment[J]. Am J Perinatol, 2020, 37(6):626-632.
[7] Aguilar-Rodríguez M, León-Castro JC, Álvarez-Cerezo M, et al. The effectiveness of an oral sensorimotor stimulation protocol for the early achievement of exclusive oral feeding in premature infants. A randomized, controlled trial[J]. Phys Occup Ther Pediatr, 2020, 40(4):371-383.
[8] Song DL, Jegatheesan P, Nafday S, et al. Patterned frequency-modulated oral stimulation in preterm infants:a multicenter randomized controlled trial[J]. PLoS One, 2019, 14(2):e0212675.
[9] Grassi A, Sgherri G, Chorna O, et al. Early intervention to improve sucking in preterm newborns:a systematic review of quantitative studies[J]. Adv Neonatal Care, 2019, 19(2):97-109.
[10] 中国医师协会新生儿科医师分会循证专业委员会. 早产儿喂养不耐受临床诊疗指南(2020)[J]. 中国当代儿科杂志, 2020, 22(10):1047-1055.
[11] 中国康复医学会儿童康复专业委员会, 中国残疾人康复协会小儿脑性瘫痪康复专业委员会,《中国脑性瘫痪康复指南》编委会. 中国脑性瘫痪康复指南(2015):第二部分[J]. 中国康复医学杂志, 2015, 30(8):858-866.
[12] 程国强, 胡勇, 庄德义, 等. 振幅整合脑电图监测不同胎龄早产儿宫外环境下脑发育的多中心观察性研究[J]. 中国循证儿科杂志, 2015, 10(2):108-113.
[13] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 4版. 北京:人民卫生出版社, 2011.
[14] 中华医学会儿科学分会新生儿学组. 早产儿管理指南[J]. 中国当代儿科杂志, 2005, 7(1):1-7.
[15] Fucile S, Gisel EG. Sensorimotor interventions improve growth and motor function in preterm infants[J]. Neonatal Netw, 2010, 29(6):359-366.
[16] Burdjalov VF, Baumgart S, Spitzer AR. Cerebral function monitoring:a new scoring system for the evaluation of brain maturation in neonates[J]. Pediatrics, 2003, 112(4):855-861.
[17] 邢珊, 刘俐, 李改莲, 等. NBNA评分在评价早产儿脑发育、脑损伤及预后中的应用[J]. 中国儿童保健杂志, 2016, 24(2):191-194.
[18] Xiong T, Gonzalez F, Mu DZ. An overview of risk factors for poor neurodevelopmental outcome associated with prematurity[J]. World J Pediatr, 2012, 8(4):293-300.
[19] Bruns N, Dransfeld F, Hüning B, et al. Comparison of two common aEEG classifications for the prediction of neurodevelopmental outcome in preterm infants[J]. Eur J Pediatr, 2017, 176(2):163-171.
[20] Bastani F, Rajai N, Farsi Z, et al. The effects of kangaroo care on the sleep and wake states of preterm infants[J]. J Nurs Res, 2017, 25(3):231-239.
[21] Carstens E, Iodi Carstens M, Dessirier JM, et al. It hurts so good:oral irritation by spices and carbonated drinks and the underlying neural mechanisms[J]. Food Qual Prefer, 2002, 13(7-8):431-443.
[22] 周梅, 尹华英, 程茜, 等. 无明显脑损伤早产儿早期口腔吸吮模式与6月龄时神经发育结局相关性研究[J]. 中国循证儿科杂志, 2016, 11(1):8-12.
[23] 黄海燕. 早产儿神经系统发育结局的研究进展[J]. 中国儿童保健杂志, 2016, 24(2):153-155.
[24] 蔡炜, 陶亚琴, 姜善雨. 四联早期口腔运动干预对早产儿体质量和经口喂养效果的影响[J]. 齐鲁护理杂志, 2019, 25(13):111-113.
[25] 方灿然, 张莲玉, 章容, 等. 口腔运动干预改善早产儿吸吮能力的临床研究[J]. 西南医科大学学报, 2018, 41(5):449-452.
[26] van Beek PE, Claessens NHP, Makropoulos A, et al. Increase in brain volumes after implementation of a nutrition regimen in infants born extremely preterm[J]. J Pediatr, 2020, 223:57-63.e5.
[27] 贾琼, 童笑梅. 早产儿菌群特征及与疾病关系的研究进展[J]. 中国当代儿科杂志, 2020, 22(11):1240-1244.