目的 分析不同出生体重与0～6月龄儿童神经心理发育结局的关系,为儿童早期临床干预提供参考依据。 方法 选取2021年1月—2023年12月于甘肃省妇幼保健院儿童保健门诊就诊的2 572名儿童为研究对象,采用0～6岁儿童发育行为评估量表评价儿童神经心理发育水平,采用二元logistic回归分析出生体重与儿童神经心理发育结局的关系。 结果 总发育异常(发育障碍或临界低值)率为7.8%(201/2 572)。不同出生体重儿童总发育商、大运动发育商、适应能力发育商比较,差异有统计学意义(P＜0.05)。不同出生体重儿童总体(χ2=57.271)、大运动(χ2=22.037)、精细动作(χ2=12.400)、适应能力(χ2=20.828)、语言(χ2=14.570)、社交行为(χ2=28.267)发育异常率差异具有统计学意义(P＜0.05)。中下(OR=0.48,95%CI:0.30～0.76)、中等(OR=0.38,95%CI:0.24～0.60)和中上水平(OR=0.34,95%CI: 0.18～0.62)出生体重是儿童发育障碍或临界低值的保护因素(P＜0.01);中等水平出生体重是儿童大运动发育障碍或临界低值的保护因素(OR=0.66,95%CI:0.48～0.90,P＜0.01);中上水平出生体重是儿童适应能力发育障碍或临界低值的保护因素(OR=0.61,95%CI:0.41～0.91,P＜0.05);中等(OR=0.62,95%CI:0.42～0.91;OR=0.47,95%CI:0.26～0.86)和中上水平(OR=0.61,95%CI:0.39～0.96;OR=0.47,95%CI:0.22～0.99)出生体重是儿童语言和社交行为发育障碍或临界低值的保护因素(P＜0.05)。与低出生体重儿童相比,高水平出生体重对儿童各能区发育的影响均无统计学意义(P＞0.05)。 结论 在临床随访中,应重点关注低出生体重、中下水平出生体重及高出生体重儿童,及时进行管理及干预,改善其神经心理发育结局。
Abstract
Objective To analyze the association between birth weight and neuropsychological developmental outcomes in children aged 0 - 6 months, in order to provide a reference for early clinical intervention. Methods A total of 2 572 children who visited the Child Health Care Clinic of Gansu Provincial Maternal and Child Health Hospital from January 2021 to December 2023 were enrolled.Neuropsychological development was assessed using the Developmental Behavior Assessment Scale for Children Aged 0 - 6 Years, and the relationship between birth weight and developmental outcomes was analyzed using binary logistic regression. Results The rate of overall developmental abnormality(developmental delay or borderline impairment was 7.8%(201/2 572).Significant differences were observed in the overall developmental quotient (DQ), gross motor DQ, and adaptive DQ among children with different birth weights (P<0.05).The abnormal development rates in overall (χ2=57.271), gross motor (χ2=22.037), fine motor (χ2=12.400), adaptive ability (χ2=20.828), language (χ2=14.570), and social behavior (χ2=28.267) domains also varied significantly by birth weight (P<0.05).Compared to low birth weight, below-average (OR=0.48, 95% CI: 0.30 - 0.76), average (OR=0.38, 95%CI: 0.24 - 0.60), and above-average birth weight (OR=0.34, 95%CI: 0.18 - 0.62) were protective factors against developmental delay or borderline impairment (P<0.01).Average birth weight was protective against gross motor delay (OR=0.66, 95%CI: 0.48 - 0.90, P < 0.01), while above-average birth weight reduced the risk of adaptive ability delay (OR=0.61, 95%CI: 0.41 - 0.91, P<0.05).Additionally, average (OR=0.62, 95%CI: 0.42 - 0.91; OR=0.47, 95%CI: 0.26 - 0.86) and above-average birth weight (OR=0.61, 95%CI: 0.39 - 0.96; OR=0.47, 95%CI: 0.22 - 0.99) were protective against language and social behavior delays (P<0.05).However, high birth weight showed no significant effect on any developmental domain compared to low birth weight (P>0.05). Conclusion Clinical follow-up should prioritize children with low, below-average, and high birth weight, implementing timely management and interventions to optimize neuropsychological development.
关键词
出生体重 /
神经心理发育 /
发育迟缓 /
儿童
Key words
birth weight /
neuropsychological development /
development delay /
children
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基金
甘肃省卫生健康行业科研计划(GSWSKY2021-001)
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