Objective To study the effect of early intervention on physical and neuropsychological development of preterm small for gestational age infants(SGA)during hospitalization and after discharge in Neonatal Intensive Care Unit(NICU), in order to provide reference for the intervention of preterm high-risk infants. Methods Preterm SGAs hospitalized in NICU from October 2016 to February 2019 were enrolled in observation group (n=103), who received early intervention during hospitalization and after discharge.And those hospitalized in this hospital but did not took early intervention measures were selected as control group (n=89).Physical development indexes of the two groups were recorded.The 20 items of neuromotor assessment at 0-1 year old(INMA) and the Bailey Infant Development scale(BISDⅡ)were used for assessment at the critical age, and the results were compared between the two groups. Results At the corrected age of 6 and 12 months, there was no significant difference on body weight and length.However, there was significant difference on head circumference between observation group and control group at the corrected age of 12 months (t=-2.260, P=0.032).At the age of 18 months, there were significant differences on body weight, body length and head circumference between the two groups (t=-2.652, -3.381, -2.627, P<0.05).The catch-up growth rates of body weight and head circumference in observation group were significantly higher than those in control group at the corrected age of 6 months (χ2=3.891, 4.444, P＜0.05).And the catch-up growth rate of body length in observation group was also higher than that in control group (χ2=4.516, P=0.034).INMA results indicated that abnormal rate of observation group was lower than that of control group (χ2=4.401, 4.786, P<0.05).Moreover, the psychomotor development index (PDI) and the mental development index (MDI) in observation group were significantly higher than those in control group at the corrected age of 12 months and 18 months(t=2.645, 3.492, 2.427, 2.437, P＜0.05). Conclusion Early intervention for premature SGAs can promote their physical and neuropsychological development, facilitate early catch-up growth, reduce neurological sequelae, thereby achieving the development of healthy growth tracks of this kind of high-risk children.
Key words
premature infants /
small for gestational age infant /
neuropsychological development /
physical development
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Ng SM, Pintus D, Turner MA.Extreme premature small for gestational age infants have appropriate catch-up growth at term equivalence compared with extreme premature appropriate for gestational age infants[J].J Clin Res Pediatr Endocrinol, 2019, 11(1):104-108.
[2] Pietza J, Peter J, Graf R, et al.Physical growth and neurodevelopmental outcome of nonhandicapped low-risk children born preterm[J].Early Hum Dev, 2004, 79(2):131- 143.
[3] 邵肖梅, 叶鸿瑁, 丘小汕.实用新生儿学[M].5 版.北京:人民卫生出版社, 2019:577, 598, 663-664.
[4] Martin A, Connelly A, Bland RM, et al.Health impact of catch-up growth in low-birth weight infants:systematic review, evidence appraisal, and meta-analysis[J].Matern Child Nutr, 2016, 13(1):e12297-e12310.
[5] De Jesus LC, Pappas A, Shankaran S, et al.Outcomes of small for gestational age infants born at<27 weeks'gestation[J].J Pediatr, 2013, 163(1):55-60.e1-e3.
[6] Mürner-Lavanchy IM, Kidokoro H, Thompson DK, et al.Thirteen-year outcomes in very preterm children associated with diffuse excessive high signal intensity on neonatal magnetic resonance imaging[J].J Pediatr, 2019, 206:66-71.e1.
[7] Brodszki J, Morsing E, Malcus P, et al.Early intervention in management of very preterm growth-restricted fetuses:2-year outcome of infants delivered on fetal indication before 30 gestational weeks[J].Ultrasound Obstet Gynecol, 2009, 34(3):288-296.
[8] Spittle A, Orton J, Anderson PJ, et al.Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairmentin preterm infants[J].Cochrane Database Syst Rev, 2015, 11:CD005495.
[9] Puthussery S, Chutiyami M, Tseng PC, et al.Effectiveness of early intervention programs for parents of preterm infants:a meta-review of systematic reviews[J].BMC Pediatr, 2018, 18:223.
[10] Takeuchi A, Yorifuji T, Hattori M, et al.Catch-up growth and behavioral development among preterm, small-for-gestational-age children:a nationwide Japanese population-based study[J].Brain Dev, 2019, 41(5):397-405.
[11] Spittle A, Treyvaud K.The role of early developmental intervention to influence neurobehavioral outcomes of children born preterm[J].Semin Perinatol, 2016, 40(8):542-548.
[12] Shi H, Yang X, Wu D, et al.Insights into infancy weight gain patterns for term small-for-gestational-age babies[J].Nutr J, 2018, 29, 17(1):97.
[13] SpittleAJ, Barton S, Treyvaud K, et al.School-age outcomes of early intervention for preterm infants and their parents:a randomized trial[J].Pediatrics, 2016, 138(6):58-87.
[14] Spittle AJ, Treyvaud K, Lee KJ, et al.The role of social risk in an early preventative care programme for infants born very preterm:a randomized controlled trial[J].Dev Med Child Neurol, 2018, 60(1):54-62.
PDF(664 KB)
