目的 分析超早产儿早期(0～2岁)的体格及神经运动发育特点及存在的问题,为提高及改善超早产儿远期生存质量提供科学依据。方法 分析2016—2019年在南方医科大学附属深圳妇幼保健院高危儿门诊随访的258例超早产儿的体格发育资料,与中国九城市(2005年)的0～2岁儿童的体格发育数据进行比较,对比不同年龄体格发育指标(体重、身长、头围)Z值以及每个指标在不同年龄中小于第10百分位(＜P₁₀)及小于第3百分位(＜P₃)的分布情况;并用贝利Ⅱ婴幼儿量表分别在矫正6、12、18、24月龄进行发育评估。结果 1)超早产儿矫正2岁时体格追赶发育仍不理想,其中身长较好,其次为体重,头围最缓慢,男童身长、体重、头围的Z值分别为:-0.31、-0.51、-0.87,女童为:-0.22、-0.43、-0.54;2)超早产儿矫正2岁以内身长、体重、头围＜P₁₀及＜P₃占比明显高于同龄儿童的理论值P₁₀和P₃,其中男童矫正2岁时＜P₁₀的对应值分别为17.78、22.22、28.89,＜P₃的对应值为2.22,13.33,15.56;女童＜P₁₀的对应值为13.04、26.09、 21.73;＜P₃的对应值为8.70、17.39、13.04,身长及体重＜P₁₀及＜P₃的占比随着年龄的增长有逐渐降低的趋势,头围在2岁以内均维持较高水平;3)超早产儿矫正2岁时的智能及运动发育水平与同龄足月儿存在较大差距,2岁以内呈逐渐追赶趋势,女童的发育略优于男童,差异无统计学意义(P＞0.05)。结论 1)超早产儿矫正2岁以内的体格发育仍然未完成追赶发育,其中身长追赶较好,体重次之,头围追赶最缓慢,早期营养强化的重点应侧重头围及体重的改善。2)超早产儿矫正2岁以内的运动及智能发育均呈逐渐上升趋势,但与同龄儿童比较存在较大差距,应强化训练至2岁以后。

Objective To analyze the physical and neuromotor development characteristics and existing problems of extremely preterm infants in the earlylife stage(0 to 2 years old), so as to provide scientific basis for improving the long-term quality of life of extremely preterm infants. Methods The physical development data of 258 extremely preterm infants followed up in the high-risk infant clinic of Shenzhen Maternity & Child Healthcare Hospital from 2016 to 2019 were analyzed and compared with the physical development data of children aged 0 to 2 years in nine cities of China in 2005. Physical development indicators(weight, length and head circumference), the standard deviation Z and the distribution of each indicator less than the 10th percentile(＜P₁₀) and less than the 3th percentile(＜P₃) were compared among different age groups. The development of infants was evaluated by Bayley Ⅱ Infant Scale at the corrected age of 6, 12, 18 and 24 months. Results 1) At the corrected age of 2 years old, the physical catch-up development of extremely preterm infants was still not ideal, in which the body length was better, followed by the weight, while the head circumference developed most slowly. The Z values of body length, weight and head circumference of boys were -0.31, -0.51, -0.87, and those of girls were -0.22, -0.43, -0.54. 2) The proportions of length, weight and head circumference <P₁₀ and <P₃ in extremely preterm infants within corrected age of 2 years old were significantly higher than the theoretical values for children with the same age. For boys at the corrected age of 2 years old, the corresponding values of body length, weight and head circumference < P₁₀ were 17.78, 22.22 and 28.89, respectively, while the corresponding values of body length, weight and head circumference < P₃ were 2.22, 13.33 and 15.56, respectively. For girls at the corrected age of 2 years old, the corresponding values of body length, weight and head circumference < P₁₀ were 13.04, 26.09 and 21.73, respectively, while the corresponding values of body length, weight and head circumference < P₃ were 8.70, 17.39 and 13.04, respectively. The proportions of body length and weight < P₁₀ decreased with age, and the proportion of head circumference maintained a high level within 2 years old. 3) The intelligence and motor development level of extremely preterm infants at the corrected age of 2 years old had a large gap with that of full-term infants with the same age. There was an upward trend of gradually catching up within the age of 2 years. The development of girls was slightly better than that of boys, but the difference was not significant(P>0.05). Conclusions 1) The physical development within corrected age of 2 years old after preterm birth is still not complete catch-up development. The catch-up of body length is ideal, followed by body weight, while the catch-up of head circumference is the slowest. Early nutrition enhancement should be focused on the improvement of head circumference and body weight. 2) The motor and intellectual development of extremely preterm infants within the corrected age of 2 years old shows a gradual increase, but there is a large gap compared to children of the same age and intensive training should be provided until 2 years old.