目的 探索不同出生胎龄对婴幼儿运动、认知等神经行为能力的影响,为二孩政策后儿童保健服务模式的调整提供线索。方法 通过方便抽样的方法,采用贝莉Ⅲ筛查量表对上海某区医院2017年1-4月体检的婴幼儿(2 646例)进行调查。结果 高龄母亲和非高龄母亲组分娩儿童的大运动、精细运动和认知能力差异均有统计学意义(t=2.94、2.80、2.68,P<0.05);通过多因素Logistic分析,调整母亲分娩年龄、性别、出生体重和不同胎龄因素,结果显示早产儿大运动落后风险是足月儿的1.960倍(OR=1.960,95%CI:1.264~3.037),早期儿精细运动落后风险是足月儿的1.192倍(OR=1.192,95%CI:1.006~1.412)。结论 与足月儿相比,早产儿发生大运动落后风险增加,早期儿发生精细运动落后风险增加。
Abstract
Objective To explore the influence of different gestational ages on infants′ motor and cognitive neurobehavioral abilities, in order to provide clues for the adjustment of child health care service model after the two-child policy. Methods A total of 2 646 infants and young children who underwent physical examinations in a district hospital in Shanghai from January to April 2017 were investigated by a convenience sampling method using the Bayley Ⅲ Screening Scale. Results There were significant differences in gross motor, fine motor and cognitive development between children born to women with advanced age and younger women(t=2.94, 2.80, 2.68, P＜0.05).After adjusted for maternal age, gender, birth weight and gestational age, Logistic regression analysis showed that the risk of gross motor development retardation in preterm infants was 1.960 times higher than that in full-term infants(OR=1.960, 95%CI:1.264-3.037).The risk of fine motor in early term infants were 1.192 times higher than that in full-berm infants(OR=1.192, 95%CI:1.006-1.412). Conclusion Compared with full term infants, preterm infants have an increased risk of gross motor retardation, and early term infants have an increased risk of fine motor retardation.
关键词
胎龄 /
运动能力 /
认知能力
Key words
gestational age /
motor ability /
cognitive development
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参考文献
[1] Listed N.ACOG Committee Opinion No 579: Definition of term pregnancy[J].Obstet Gynecol,2013,122(5):1139-1140.
[2] 朱丽,张蓉,张淑莲,等.中国不同胎龄新生儿出生体重曲线研制[J].中华儿科杂志, 2015, 53(2): 97-103.
[3] Azari N, Soleimani F, Vameghi R, et al.A psychometric study of the bayley scales of infant and toddler development in persian language children[J].Iranian Journal of Child Neurology, 2017, 11(1):50.
[4] 林森然, 杨青, 曹志娟,等.BSID-Ⅲ筛查测试在上海地区使用信度的初步研究 [J].中国妇幼健康研究, 2017,13(12):1500-1503.
[5] 林森然,李筠,杨青,等.贝莉-Ⅲ婴幼儿发育筛查测试在上海地区应用效度初步分析[J].中国儿童保健杂志,2018,26(10):1060-1063,1067.
[6] Council on children with disabilities, Section on Devolopmental Behavioral Pediatrics, Bright futures Steering Committee, et al.Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening[J].Pediatrics, 2006, 118(1): 405-420.
[7] Tepper NK, Godfrey EM, Folger SG, et al.Hormonal contraceptive use among women of older reproductive age: considering risks and benefits [J].J Womens Health, 2018, 27(4):413-417.
[8] 周辉,闫清波.320例高龄产妇临床妊娠分析[J].中国计划生育和妇产科, 2015, 6: 60-62.
[9] 邢肖肖.胎儿脐动脉阻力指数正常和增高的椎动脉及大脑中动脉的超声研究[N].包头医学院学报,2015,31(9):26-27.
[10] 吕峻峰,施玉麒,黄云丽, 等.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.
[11] Aijaz F, Bruno HGF, Gunnar S, et al.Growth in 10- to 12-year-old children born at 23 to 25 weeks′ gestation in the 1990s: a Swedish national prospective follow-up study [J].Pediatrics, 2006, 118(5): 1452-1465.
[12] Sengoku T, Murray KM, Wilson ME.Neonatal hyperoxia induces alterations in neurotrophin gene expression [J].Int J Dev Neurosci, 2016, 48: 31-37.
[13] 政晓果, 辛倩倩, 杨慧敏,等.3岁以下儿童精细动作发育情况的影响因素分析[J].中国妇幼保健, 2018,33(23):5562-5564.
[14] Bos AF, Van Braeckel KNJA, Hitzert MM, et al.Development of fine motor skills in preterm infants[J].Dev Med Child Neurol, 2013, 55(Suppl 4) :1-4.
[15] Chojnacki MR, Holscher HD, Balbinot AR, et al.Relations between mode of birth delivery and timing of developmental milestones and adiposity in preadolescence: A retrospective study[J].Early Hum Dev, 2019,129:52-59.
[16] Tomporowski PD, Mccullick B, Pendleton DM, et al.Exercise and children′s cognition:The role of exercise characteristics and a place for metacognition[J].J Sport Health Sci,2015, 4(1): 47-55.
[17] Laptook A R.Neurologic and metabolic issues in moderately preterm, late preterm, and early term infants[J].Clin Perinatol, 2013, 40(4):723.
[18] Girard LC, Doyle O, Tremblay RE.Breastfeeding, cognitive and noncognitive development in early childhood: a population study[J].Pediatrics, 2017, 139(4):e20161848.
基金
国家自然科学基金委员会面上项目(81673179);上海市申康医院发展中心适宜技术联合开发推广应用项目(SHDC12016239);上海市科学技术委员会课题(18140903100,19140903100)
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