目的 了解早产儿早期运动发育状况,分析影响早产儿运动发育的相关因素,为构建早产儿出院后早期运动干预模式提供依据。方法 采用方便抽样选择2018年11月至2019年3月出生,并在四川大学华西第二医院儿童保健科建档的361例早产儿,以矫正3个月Alberta 婴儿运动量表(AIMS)评分作为早产儿运动发育的结局指标。结果 361例早产儿中,311例(86.1%)AIMS评分>P25,即运动发育正常;40例(11.1%)AIMS评分在P11~P25之间,即可疑运动发育迟缓;10例(2.8%)AIMS评分为≤P10,即运动发育迟缓。Logistic回归分析显示,矫正3月龄体重(OR=0.347,95%CI:0.174~0.691,P=0.003)、女性(OR=0.415,95%CI:0.202~0.850,P=0.016)是早产儿运动发育迟缓的保护因素。结论 早产儿出院后早期运动发育状况整体较好,但在后期的随访过程中,需重点关注体重追赶缓慢的早产男童,以尽早发现早产儿运动发育迟缓情况并给予干预。
Abstract
Objective To know about the motor development status of preterm infants, and to identify its influencing factors, so as to provide evidence for constructing early motor intervention model for preterm infants after discharge. Methods A convenience sampling method was used to select 361 preterm infants, who were born from November 2018 to March 2019 and registered in the Child Healthcare Department of West China Second University Hospital. Alberta Infant Motor Scale(AIMS) score of infants at the corrected age of 3 months old was used as the outcome indicator of motor development. Results Among 361 preterm infants, 311(86.1%) had normal motor performance(AIMS score >P25), and 40(11.1%) showed suspect motor performance(P11≤AIMS score≤P25), and only 10(2.8%) had atypical motor development or motor delay(AIMS score≤P10). Logistic regression analysis showed that weight at the corrected age of 3 months old(OR=0.347, 95%CI:0.174 - 0.691, P=0.003) and female(OR=0.415, 95%CI:0.202 - 0.850, P=0.016) were protective factors for motor delay of preterm infants. Conclusions The early motor development of preterm infants after discharge is generally good. However, it is still necessary to pay more attention to the preterm infants who are boys, especially those with slower body weight catch-up.
关键词
早产儿 /
运动发育 /
AIMS量表
Key words
preterm infant /
motor development /
Alberta Infant Motor Scale
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参考文献
[1] 张小松,赵更力,杨慧霞,等.15家城市医疗机构早产发生情况及影响因素分析[J].中华围产医学杂志,2016,19(6):456-461.
[2] 周伟勤.极早产儿主要临床问题回顾性分析及人脐带血间充质干细胞制备研究[D].广州:南方医科大学,2013.
[3] Sammallahti S, Kajantie E, Matinolli HM, et al. Nutrition after preterm birth and adult neurocognitive outcomes[J]. PLoS One, 2017,12(9):e0185632
[4] 桑田,王颖,胡秀丽,等.极低出生体重儿体格发育与神经发育关系的研究[J].中国新生儿科杂志,2016,31(3):161-167.
[5] 郑拉洁,苏卫东,黄欢欢,等.早产小于胎龄儿早期干预对体格发育及神经心理发育影响的应用研究[J].中国康复医学杂志,2021,36(5):559-563.
[6] 林春,孟兆祥,任素伟,等. 全身运动评估指导下的分级早期干预对高危儿预后的影响[J].中国康复医学杂志,2021,36(2):161-165.
[7] 黄真,李明.发育中婴幼儿的运动评估-Alberta婴儿运动量表[M].北京:北京大学出版社,2009:163-166.
[8] 王翠,李一芳,黄真,等.Alberta婴儿运动量表的效度研究[J].中国康复医学杂志,2018,33(1):55-58.
[9] 王玮,王翠,席宇诚,等. Alberta 婴儿运动量表在高危儿中的信度研究[J].中国康复医学杂志,2012,27(10):913-916.
[10] Tupsila R, Bennett S, Mato L, et al. Gross motor development of Thai healthy full-term infants aged from birth to 14 months using the Alberta Infant Motor Scale:Inter individual variability[J]. Early Hum Dev, 2020,151:105169.
[11] 王翠,李一芳,黄真,等.Alberta婴儿运动量表与Peabody粗大运动发育量表在高危儿中的预测能力研究[J].中国康复医学杂志,2019,34(3):293-296.
[12] 林碧云,危曼,邵肖梅,等. Alberta婴儿运动量表对新生儿重症监护室高危儿出院后筛查运动发育落后的准确性研究[J].中国循证儿科杂志,2015,10(2):81-84.
[13] Fuentefria RDN, Silveira RC, Procianoy RS. Motor development of preterm infants assessed by the Alberta Infant Motor Scale:Systematic review article[J]. J Pediatr,2017,93(4):328-342.
[14] Maia PC, Silva LP, Oliveira M, et al. Motor development of preterm and term infants:Using the Alberta Infant Motor Scale[J]. Acta Paulista De Enfermagem, 2011,24(5):670-675.
[15] 吴利,王淮燕,李玖玲,等.贝利婴幼儿发展量表(第3版)在筛查测试婴幼儿认知发育中的应用[J].实用临床医药杂志,2021,25(3):33-35.
[16] 王成举,胡斌,屈福祥,等.婴儿运动表现测试在早产儿运动评估中的应用[J].中国儿童保健杂志,2020,28(7):744-747.
[17] 石永言.超早产儿或超低出生体重儿与2岁时神经发育及社会情绪发展存在因果关系[J].国际儿科学杂志,2022,49(1):14-14.
[18] 刘佳,于杨,柳亚杰.早产和足月低体重儿的神经心理发育水平[J].中国健康心理学杂志,2018,26(8):1190-1193.
[19] Allotey J, Zamora J, Cheong-See F, et al. Cognitive, motor, behavioural and academic performances of children born preterm:A meta-analysis and systematic review involving 64061 children[J]. BJOG, 2018,125(1):16-25.
[20] Pascal A,Govaert P, Oostra A, et al. Neurodevelopmental outcome in very preterm and very-low-birthweight infants born over the past decade:A meta-analytic review[J]. Dev Med Child Neurol, 2018,60(4):342-355.
[21] Prins SA, von Lindern JS, van Dijk S, et al. Motor development of premature infants born between 32 and 34 weeks[J]. Int J Pediatr, 2010,2010:462048 [22] Formiga C, Nonato J, Amaral L, et al. Comparison of the motor development in preterm infants from two brazilian regional samples[J]. Revista Brasileira De Crescimento E Desenvolvimento Humano, 2013,23(3):352-356.
[23] 胡燕丽,吕兰秋.早产儿团体干预模式的研究概述[J].中国儿童保健杂志,2015,23(11):1157-1159.
[24] Clearfield MW. The role of crawling and walking experience in infant spatial memory[J]. J Exp Child Psychol, 2004,89(3):214-241.
[25] Whitney PG, Green JA. Changes in infants' affect related to the onset of independent locomotion[J]. InfantBehav Dev, 2011,34(3):459-466.
[26] Clearfield MW. Learning to walk changes infants' social interactions[J]. Infant Behav Dev, 2011,34(1):15-25.
[27] Murray GK,Veijola J, Moilanen K, et al. Infant motor development is associated with adult cognitive categorisation in a longitudinal birth cohort study[J]. J Child Psychol Psychiatry, 2006,47(1):25-29.
[28] Wang CJ,Mcglynn EA, Brook RH, et al. Quality-of-care indicators for the neuro developmental follow-up of very low birth weight children:results of an expert panel process[J]. Pediatrics. 2006, 117(6):2080-2092.
[29] 孔娟,梁少珍,陈海凤,等.出生早期体重增长速率对早产儿矫正12月龄时神经发育的影响[J].中国当代儿科杂志,2021,23(3):236-241.
[30] 陆岸锋,黄海燕,黄国盛,等.早产儿408例体格生长与神经运动发育纵向研究[J]. 中国儿童保健杂志,2018,26(5):472-474,478.
[31] Sammallahti S, Pyhälä R, Lahti M, et al. Infant growth after preterm birth and neurocognitive abilities in young adulthood[J]. J Pediatr, 2014.165(6):1109-1115.
[32] Belfort MB,Rifas-Shiman SL, Sullivan T, et al. Infant growth before and after term:Effects on neurodevelopment in preterm infants[J].Pediatrics, 2011,128(4):899-906.
[33] Belfort MB, Gillman MW,Buka SL, et al. Preterm infant linear growth and adiposity gain:Trade-offs for later weight status and intelligence quotient[J]. J Pediatr, 2013,163(6):1564-1569.
[34] Cormack BE, Harding JE, Miller SP, et al. The Influence of early nutrition on brain growth and neurodevelopment in extremely preterm babies:A narrative review[J]. Nutrients,2019,11(9):2029.
[35] 吴迪. 3~6岁儿童身体移动能力发展及其影响因素研究[D].上海:华东师范大学,2020.
[36] 金岚,李培培,高明娟,等. 1038例0~2岁婴幼儿发育水平监测结果分析[J]. 中国妇幼保健,2019,34(17):3970.
[37] Printzlau F, Wolstencroft J, Skuse DH. Cognitive,behavioral and neural consequences of sex chromosome aneuploidy[J]. J Neurosci Res, 2017,95(1-2):311-319.
[38] Shea SE. Intellectual disability(mental retardation)[J].Pediatr Rev, 2012,33(3):110-121.
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