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

Effect of weight growth velocity in the early stage after birth on neurodevelopment of preterm infants at the corrected age of 12 months

摘要:

目的 研究早产儿出生早期的体重增长速率对矫正12月龄时神经发育的影响。方法 收集2015年7月1日至2019年12月31日期间在广州医科大学附属第三医院新生儿科出院，且在该院高危儿门诊随访的早产儿的相关资料，根据其出生至矫正胎龄40周时的体重增长速率分为低速率组[< 10 g/（kg·d）；21例]和高速率组[≥10 g/（kg·d）；87例]，在矫正3月、6月、12月龄时采用Gesell发育量表进行神经发育评估，并比较两组间的差异。结果 在矫正12月龄时，低速率组的精细运动能评分明显低于高速率组（P < 0.05），语言能评分异常率明显高于高速率组（P < 0.05）。其中在出生体重 < 1 500 g与出生体重≥1 500 g的早产儿中，低速率组精细运动能评分均较高速率组评分低（P < 0.05）；出生体重≥1 500 g早产儿中，低速率组语言能评分异常率较高速率组高（P < 0.05）。结论 早产儿出生至矫正胎龄40周时的体重增长速率可能影响其12月龄时的精细运动及语言发育，但有待更大样本量的研究进一步论证。

Abstract:

Objective To study the effect of weight growth velocity in the early stage after birth on the neurodevelopment of preterm infants at the corrected age of 12 months. Methods Related data were collected from the preterm infants who were discharged from the Department of Neonatology, Third Affiliated Hospital of Guangzhou Medical University, from July 1, 2015 to December 31, 2019 and were followed up at the outpatient service of high-risk infants. According to the weight growth velocity from birth to the corrected gestational age of 40 weeks, the infants were divided into two groups: low velocity [< 10 g/(kg·d); n=21] and high velocity [≥10 g/(kg·d); n=87]. At the corrected ages of 3, 6, and 12 months, Gesell Developmental Schedules were used to evaluate and compare neurodevelopment between the two groups. Results At the corrected age of 12 months, the low velocity group had a significantly lower score of fine motor (P < 0.05) and a significantly higher abnormal rate of language ability score compared with high velocity (P < 0.05). For the preterm infants with a birth weight of < 1 500 g or ≥1 500 g, the low velocity group had a significantly lower score of fine motor than the high velocity group (P < 0.05); for the preterm infants with a birth weight of ≥1 500 g, the low velocity group had a significantly higher abnormal rate of language ability score than the high velocity group (P < 0.05). Conclusions The weight growth velocity from birth to the corrected age of 40 weeks affects the development of fine motor and language in preterm infants at the corrected age of 12 months; however it needs to be further verified by large-sample studies.