目的 探讨早产儿出院后矫正生理月龄至18月时生长发育状况,为提高早产儿生命质量提供理论依据。方法 纵向研究合肥市妇幼保健院自2012-2015年于合肥市妇幼保健院高危儿随访中心随访的174例早产儿(其中小于胎龄儿64例,适于胎龄儿110例),同期,按矫正月龄随机抽取本院儿童保健科常规体检的同龄足月儿183例作为对照组。在早产儿矫正生理月龄6、12、18个月时,分别测量两组的体格发育指标和运动发育指标,并进行分析评估。结果 矫正生理月龄6月时早产儿体重、身长和头围三方面体格发育指标均落后于足月儿,差异有统计学意义(P<0.01);但在矫正生理月龄12、18月时早产儿大运动发育已追赶上同龄足月儿(P>0.05),而早产儿尤其小于胎龄儿在精细动作、语言、个人-社会、适应行为均存在差距(P<0.05)。结论 早产儿出生后前半年体格发育均落后于正常足月儿,尤其小于胎龄儿早产儿的生长潜力低于适于胎龄儿早产儿。早期充分的营养供给和智能训练对于提高早产儿的生命质量将具有潜在的临床价值。
Abstract
Objective To explore the features of physique and motor development of preterm infants at the corrected age of 18 months and provide the theoretical basis for the improvement of their health related quality of life. Methods A prospective cohort study was performed from 2012 to 2015 at the following-up center of high-risk children in Maternal and Child Health Care Hospital,with 174 preterm infants and 183 term infant as the control group.Physique and motor development parameters were compared at the corrected age of 6,12 and 18 months,respectively. Results Preterm infants developed statistically significant worse on weight,length and head circumference at the corrected age of 6 months (P<0.01).Although,there was no difference in gross motor scores for the preterm infants at corrected age of 12 and18 months compared with the term infants.However,the preterm infants hadn't caught up with especially those who was small for gestational age (P<0.05) in the term of fine motor development and language and person society and adaptive behavior. Conclusion Preterm infants at the corrected age of 6 months hadn't caught up with the term ones,especially growing potential of who was small for gestational age was less than those appropriate for gestational age.Adequate nutrition and intelligent training for the preterm infants at the early stage might have potential value on the improvement of their life qualify.
关键词
早产儿 /
生长发育 /
适于胎龄儿 /
小于胎龄儿
Key words
preterm infants /
physical growth and development /
appropriate for gestational age /
small for gestational age
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参考文献
[1] Renato P,Ricardo P,Sergio M,et al.Brazilian multicenter study on prevalence of preterm birth and associated factors[J].BMC Pregnancy and Childbirth,2010,10(22):1-7.
[2] Shripada R.Growth monitoring of preterm infants during stay in the neonatal unit and into early childhood[J].Springer Science Business Media Dordrecht,2013,293-308.doi:10.1007/978-94-007-6812-3_15.
[3] 徐姗姗,黄红,张劲松.婴幼儿诊断性发育量表研究及应用进展[J].中国儿童保健杂志,2010,18(11):859-861.
[4] Zabransky S.Premature infants[J].Springer Healthcare,2013,13:127-149.
[5] Tanis F,Jae K.A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants[J].Fenton and Kim BMC Pediatrics,2013,13(59):1-13.
[6] Margaret P,Liza K,Camilia M.The role of nutrition in health and disease in premature infants:current knowledge gaps and defining the research agenda[M].New York.Springer Science Business Media,2013:111-132.
[7] Ian JG.Assessing nutritional requirements for preterm infants[J].New York:Springer Science Business Media,2015,25:395-406.
[8] Pampanini A,Boiani C,Marchis C.Preterm infants with severe extrauterine growth retardation(EUGR) are at high risk of growth impairment during childhood[J].Springer-Verlag Berlin Heidelberg,2014,6:33-41.
[9] 吕峻峰,施玉麒,黄云丽.早产小于胎龄儿和适于胎龄儿生长发育状况随访分析[J].临床儿科杂志,2014,32(11):1034-1038.
[10] Naoko K,Anne L,Mariangela S,et al.The associations of birth intervals with small for gestational age,preterm,and neonatal and infant mortality:a meta-analysis[J].BMC Public Health.,2013,13(3):1-9.
[11] Katie P,Sara R.Optimizing growth and neurocognitive development while minimalizing metabolic risk in preterm infants[J].Curr Pediatr Rep,2014,2:269-275.
[12] Anneke T,Hannah H,Ruby H,et al.The effectiveness of video interaction guidance in parents of premature infants:A multicenter randomised controlled trial[J].BMC Pediatrics,2012,12(76):1-9.
[13] Jeannette S,Chantal M,Karien E,et al.Long-term outcome in relationship to neonataltransfusion volume in extremely premature infants:a comparative cohort study.von Lindern[J].BMC Pediatrics,2011,11(48):1-6.
[14] Jane O,Jennifer M,Lisa F,et al.Challenges of neurodevelopmental follow-up for extremely preterm infants at two years[J].Early Human Development,2015,91:689-694.
基金项目:合肥市科技计划项目(2013-13)
作者简介:李小燕(1978-),女,主治医师,研究生学历,研究方向为小儿神经发育。
通信作者:王慧琴,E-mail:1871024765@qq.com
数字出版网址:http://www.cnki.net/kcms/detail/61.1346.R.20160526.1134.008.html