小于胎龄儿学龄前期神经认知功能发育研究

doi:10.11852/zgetbjzz2024-0658

摘要/Abstract

摘要： 目的了解小于胎龄儿(SGA)在学龄前期的神经认知功能发育情况并与足月适于胎龄儿(AGA)比较,为促进SGA早期发展提供依据。方法纳入2020年10月—2024年3月在青岛大学附属医院儿童保健科健康体检的49例4～＜7岁SGA为研究对象,根据目前身高是否达到同年龄同性别正常儿童身高第10百分位分为追赶生长组24例和未追赶生长组25例。纳入与病例组年龄、性别匹配的29例足月AGA为对照组。比较三组儿童韦氏幼儿智力量表第四版(WPPSI-Ⅳ)的全量表分和5个主要指数分数。结果三组儿童总智商差异有统计学意义(F=8.967,P＜0.05),其中,对照组(114.07±12.21)高于追赶生长组(103.96±11.36)和未追赶生长组(100.52±13.21)(P＜0.05),追赶生长组和未追赶生长组SGA总智商差异无统计学意义(P＞0.05)。5个主要指数中,三组儿童言语理解(F=15.077)、工作记忆(F=4.065)、加工速度(F=18.864)分数差异均有统计学意义(P＜0.05),其中未追赶生长组SGA言语理解、工作记忆、加工速度分数均低于追赶生长组SGA及对照组(P＜0.05),追赶生长组SGA言语理解分数、加工速度分数低于对照组(P＜0.05)。结论 SGA在学龄前期整体神经认知发育水平落后于足月AGA。追赶生长有益于SGA的语言理解能力,且可在工作记忆和加工速度方面对执行功能有积极效应。

关键词: 小于胎龄儿, 神经认知发育, 追赶生长, 韦氏幼儿智力量表第四版

Abstract: Objective To investigate the neurocognitive development of small-for-gestational-age(SGA) children in the preschool period, and to compare it with that of full-term appropriate-for-gestational-age(AGA) children, so as to provide basis for promoting early development of SGA children. Methods From October 2020 to March 2024, 49 SGA children aged 4 to <7 years who underwent health examinations at the Child Health Care Department of The Affiliated Hospital of Qingdao University were enrolled as study subjects. Based on whether their current height reached the 10th percentile of normal children of the same age and gender, children were divided into catch-up growth group(n=24) and non-catch-up growth group(n=25). Additionally, 29 full-term AGA children matched by age and gender with the case group were included as the control group. The full-scale scores and five primary index scores of the Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition(WPPSI-Ⅳ) were compared among the three groups. Results Significant differences in total IQ were observed among the three groups(F=8.967, P<0.05). Specifically, the control group(114.07±12.21) scored higher than the catch-up growth group(103.96±11.36) and the non-catch-up growth group(100.52±13.21)(P<0.05). However, no significant difference was found between the catch-up growth group and the non-catch-up growth group in terms of the total IQ(P>0.05). Among the five primary indices, significant differences were found in verbal comprehension(F=15.077), working memory(F=4.065), and processing speed(F=18.864) among the three groups(P<0.05). Notably, the non-catch-up growth group scored lower in verbal comprehension, working memory, and processing speed than both the catch-up growth group and the control group(P<0.05). The catch-up growth group scored lower than the control group in verbal comprehension and processing speed(P<0.05). Conclusions The overall neurocognitive development of SGA children lags behind that of full-term AGA children in the preschool period. Catch-up growth is beneficial to the verbal comprehension ability of SGA children and has a positive effect on executive functions, including working memory and processing speed.

Key words: small for gestational age, neurocognitive development, catch-up growth, Wechsler Preschool and Primary Scale of Intelligence-Ⅳ

中图分类号:

R179

房雨如, 孟秋彤, 单延春, 冉霓, 杨召川, 衣明纪. 小于胎龄儿学龄前期神经认知功能发育研究[J]. 中国儿童保健杂志, 2025, 33(6): 614-618.

FANG Yuru, MENG Qiutong, SHAN Yanchun, RAN Ni, YANG Zhaochuan, YI Mingji. Neurocognitive development of preschool children born small for gestational age[J]. Chinese Journal of Child Health Care, 2025, 33(6): 614-618.

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