目的 分析足月新生儿行为神经发育测定结局的孕期可控性影响因素,为早期预防和干预提供科学依据。方法 2017年4月-2018年3月于安徽省妇幼保健院随机抽取601对母婴为研究对象,采用新生儿行为神经测定(NBNA)对新生儿行为神经发育进行评价。通过问卷调查获得孕妇社会人口学特征、孕期健康状况和生活方式等信息。采用非条件多因素Logistic回归分析新生儿行为神经发育的影响因素。结果 在601例足月新生儿中,NBNA评分异常的新生儿有63例(10.5%)。怀孕间隔时间在1年以内(OR=2.95,95%CI:1.30～6.68)、早期(OR=2.71,95%CI:2.46～5.02)或晚期(OR=2.70,95%CI:1.34～5.44)足月儿的NBNA异常风险显著升高,而孕期每周至少1次体力运动的孕妇(OR=0.50,95%CI:0.28～0.88),其新生儿NBNA评分异常风险显著降低。在非完全足月儿中,妊娠间隔时间长组的孕妇(OR=0.31,95%CI:0.11～0.86)和有体力运动的孕妇(OR=0.45,95%CI:0.20～0.98),其新生儿NBNA异常的风险显著低于妊娠间隔时间短组。结论 妊娠间隔和孕期体力运动是影响足月新生儿行为神经发育的孕期可控性因素,在促进胎儿行为神经发育方面具有重要的公共卫生学意义。
Abstract
Objective To analyze the controllable factors affecting the outcome of neurobehavioral development in term neonates during pregnancy,in order to provide scientific basis for early prevention and intervention. Methods From April 2016 to March 2018,601 pairs of mothers and infants were randomly selected from Anhui Maternal and Child Health Hospital to evaluate the neurobehavioral development of newborns by neonatal behavioral neurological assessment (NBNA).The social demographic characteristics,health status and lifestyle of pregnant women were obtained by questionnaires. The multivariate Logistic regression analysis was used to analyze the influencing factors of neonatal neurobehavioral development. Results Among 601 full-term newborns,63 (10.5%) had abnormal NBNA scores.The risk of abnormal NBNA was significantly increased in pregnancy again within one year (OR=2.95,95%CI:1.30-6.68),early (OR=2.71,95%CI:2.46-5.02) or late (OR=2.70,95%CI:1.34-5.44)full-term infants,while the risk of abnormal NBNA was significantly reduced in pregnant women who took physical exercise at least once per week (OR=0.50,95%CI:0.28-0.88).The risk of neonatal NBNA abnormality was significantly lower in pregnant women with long gestation interval (OR=0.31,95%CI:0.11-0.86) and those with physical activity (OR=0.45,95%CI:0.20-0.98). Conclusion Pregnancy interval and physical activity during pregnancy are controllable factors affecting the behavioral neurological development of full-term newborns,which is of important public health significance in promoting fetal neurobehavioral development.
关键词
新生儿 /
行为神经发育 /
孕期可控性
Key words
neonatal /
behavioralneurological development /
controllability during pregnancy
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基金
国家自然科学基金面上项目(81872631);安徽省学术和技术带头人后备人选科研资助项目(2017H141);合肥市2016年度科技攻关计划项目(2016-67)
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