早产儿早期神经运动发育纵向随访
- 李蓓,冯菁菁,徐秀
作者信息
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Follow-up study on early neurodevelopment of preterm children.
- LI Bei,FENG Jing-jing,XU Xiu.
Author information
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文章历史
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摘要
目的 探讨早产对婴幼儿智力、运动发育及视觉认知能力的影响,为开展早产儿早期干预提供依据。方法 采用纵向随访方法,选取曾在本院新生儿科住院的55例早产儿(其中:极早产儿 25例,中晚期早产儿30例)作为研究组,40例正常足月儿作为对照组,应用Bayley-Ⅱ婴幼儿发育量表在12月龄、18月龄、24月龄和36月龄时进行评估,用智力发育指数(Mental Developmental Index,MDI)、运动发育指数(Psychomotor Developmental Index,PDI)和视觉项目通过率表示。结果 极早产儿各校正月龄MDI、PDI均较正常足月儿落后(P＜0.05);中晚期早产儿仅在校正12月龄和24月龄MDI得分与对照组存在显著性差异(P＜0.05),各校正月龄PDI得分与对照组无显著性差异(P＞0.05)。极早产儿组视觉项目通过率为46.3%,中晚期早产儿为61.5%,对照组为74.4%。 结论 早产对婴幼儿的智力、运动及视觉认知发育存在显著负面影响,在极早产儿中尤为明显,应尽早实施早期干预,促进早产儿发育。
Abstract
Objective To explore the premature effect on the mental,motor and visual cognitive development of preterm infants from 12 to 36 months of age. Method 55 preterm children(including:very preterm children 25 cases,moderately to late preterm children 30 cases)were selected,40 normal full-term children served as a control group.Bayley-Ⅱ Infant Development Scale was used to evaluate children neurodevelopment at 12,18,24 and 36 months,and the results were indicated as mental development index(MDI),psychomotor development index(PDI) and the rate of visual items passed. Results The very preterm group showed the scores of MDI and PDI were significantly lower than the full-term group at 12,18,24 and 36 months of age(P<0.05); The moderately to late preterm children showed the scores of MDI were significantly lower compared with the full-term group at 12 and 24 months of age(P<0.05),while there was no significant difference in the score of PDI between two groups(P>0.05).The rate of visual items passed among the very preterm children,the moderately to late preterm children and the control group was 46.3%,61.5% and 74.4% respectively. Conclusion Premature has the negative influence on the development of children's cognitive,motor and visual cognitive function,especially for very preterm children.The early intervention in preterm children should be implemented to promote their healthy growth as soon as possible.
关键词
Key words
neuromotor development / visual cognitive / longitudinal study / preterm children
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参考文献
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[5] Van Baar AL,Ultee K,Gunning WB,et al.Developmental course of very preterm children in relation to school outcome[J ].Dev Phys Disabil,2006,18:273-293.
[6] Hillemeier MM,Farkas G,Morgan PL,et al.Disparities in the prevalence of cognitive delay:how early do they appear?[J].Paediatr Perinat Epidemiol,2009,23:186-198.
[7] Romeo DM,Di Stefano A,Conversano M,et al.Neurodevelopmental outcome at 12 and 18 months in late preterm infants[J].Eur J Paediatr Neurol,2010,14:503-507.
[8] Woythaler MA,McCormick MC,Smith VC.Late preterm infants have worse 24-month neurodevelopmental outcomes than term infants[J].Pediatrics,2011,127(3):622-629.
[9] Gurka MJ,LoCasale-Crouch J,Blackman JA.Long-term cognition,achievement,socioemotional and behavioral development of healthy late-preterm infants[J].Arch Pediatr Adolesc Med,2010,164(6):525-532.
[10] Caravale B,Tozzi C,Albino G,et al.Cognitive development in low risk preterm infants at 3-4 years of life[J].Arch Dis Child Fetal Neonatal Ed,2005,90:474-479.
[11] 冯菁菁,徐秀,郭书娟,等.低危晚期早产儿学龄前期认知和视觉运动整和能力研究[J].中国儿童保健杂志,2011.19(12),1080-1083.
[2] Allen MC,Cristofalo E,Aucott S,et al.Neurodevelopmental outcomes of preterm infants[J].Current Opinion In Neurology,2008,21(2):123-128.
[3] Woodward LJ,Moor S,Hood KM,et al.Very preterm children show impairments across multiple neurodevelopmental domains by age 4 years[J].Arch Dis Child-Fetal Neonatal Ed,2009,94(5):339-344.
[4] Bregje AH,Bianca GO,Loekie VS,et al.Improvement of developmental outcome between 24 and 36 months corrected age in very preterm infants[J].Acta Paediatrica,2010,99(12):1801-1806.
[5] Van Baar AL,Ultee K,Gunning WB,et al.Developmental course of very preterm children in relation to school outcome[J ].Dev Phys Disabil,2006,18:273-293.
[6] Hillemeier MM,Farkas G,Morgan PL,et al.Disparities in the prevalence of cognitive delay:how early do they appear?[J].Paediatr Perinat Epidemiol,2009,23:186-198.
[7] Romeo DM,Di Stefano A,Conversano M,et al.Neurodevelopmental outcome at 12 and 18 months in late preterm infants[J].Eur J Paediatr Neurol,2010,14:503-507.
[8] Woythaler MA,McCormick MC,Smith VC.Late preterm infants have worse 24-month neurodevelopmental outcomes than term infants[J].Pediatrics,2011,127(3):622-629.
[9] Gurka MJ,LoCasale-Crouch J,Blackman JA.Long-term cognition,achievement,socioemotional and behavioral development of healthy late-preterm infants[J].Arch Pediatr Adolesc Med,2010,164(6):525-532.
[10] Caravale B,Tozzi C,Albino G,et al.Cognitive development in low risk preterm infants at 3-4 years of life[J].Arch Dis Child Fetal Neonatal Ed,2005,90:474-479.
[11] 冯菁菁,徐秀,郭书娟,等.低危晚期早产儿学龄前期认知和视觉运动整和能力研究[J].中国儿童保健杂志,2011.19(12),1080-1083.
基金
上海市公共卫生优秀学科带头人培养计划资助(GWDTR201220);上海市公共卫生重点学科建设计划资助(12GWZX0301)
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