Please wait a minute...
文章检索
预防医学  2022, Vol. 34 Issue (8): 771-775    DOI: 10.19485/j.cnki.issn2096-5087.2022.08.004
  论著 本期目录 | 过刊浏览 | 高级检索 |
早产儿体格生长和神经发育的早期综合干预效果评价
余红, 陈晓霞, 吴长划, 沈沛
绍兴市妇幼保健院儿童保健科,浙江 绍兴 312000
Effect of early comprehensive interventions on physical growth and nervedevelopment among premature infants
YU Hong, CHEN Xiaoxia, WU Changhua, SHEN Pei
Department of Child Health Care, Shaoxing Municipal Maternal and Child Health Care Hospital, Shaoxing,Zhejiang 312000, China
全文: PDF(861 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 评价早期综合干预对早产儿体格生长和神经发育的效果,为早产儿出院后随访管理提供依据。方法 选择2019—2021年绍兴市妇幼保健院出生的130例早产儿,根据胎龄和出生体重分配入高危组和低危组,实施营养支持、家长喂养发育指导等早期综合干预措施至12月龄;选择同期306名正常足月新生儿作为对照,按照基本公共卫生服务项目要求开展定期健康体检。定期测量身长、体重和头围,12月龄时采用贝利婴幼儿发展量表(中国城市版)评估智力和运动发育能力。比较3组婴儿体格发育状况、智力发育指数(MDI)和运动发育指数(PDI)。结果 早产儿130例,胎龄28~36周,出生体重1 200~3 440 g,男婴79例,其中低危早产儿组80例,高危早产儿组50例;足月儿组306人,胎龄37~42周,出生体重2 500~4 000 g,男婴162人。广义估计方程分析显示,3组婴儿身长(Wald χ2=28.664,P<0.001)、头围(Wald χ2=19.312,P=0.013)生长速度差异有统计学意义;12月龄时,3组婴儿体重(F=0.639,P=0.528)、身长(F=1.051,P=0.350)和头围(F=0.318,P=0.728)差异均无统计学意义。12月龄时高危早产儿组、低危早产儿组和足月儿组MDI异常率分别为2.00%、0%和1.31%,差异无统计学意义(χ2=1.319,P=0.517);PDI异常率分别为20.00%、7.50%和5.56%,差异有统计学意义(χ2=12.818,P=0.002)。结论 经早期综合干预,早产儿体格生长良好,MDI与足月儿相比无明显差异,但高危早产儿PDI异常率较高。建议在早产儿管理中重点关注高危早产儿运动能力的发展。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
余红
陈晓霞
吴长划
沈沛
关键词 早产儿早期综合干预体格生长智力发育指数运动发育指数    
AbstractObjective To examine the effect of early comprehensive interventions on the physical growth and nerve development among premature infants, so as to provide insights into the follow-up management of premature infants after discharge from hospital. Methods A total of 130 premature infants delivered in Shaoxing Municipal Maternal and Child Health Care Hospital from 2019 to 2021 were selected and divided into high- and low-risk groups according to gestational age and birth weight, while 306 full-term normal infants in the same hospital during the study period served as controls. All premature infants were given early comprehensive interventions until age of 12 months, including nutritional support and parental guidance of children's feeding and development, and all normal infants received periodical health checkup according to the basic public health service program. All infants received periodical measurements of height, weight and head circumference, and the 12-month intellectual and motor development ability was measured using the Bayley Scales of Infant Development revised in Chinese cities was used to assess. Infants' physical growth, mental development index (MDI) and motor development index (PDI) were compared among groups. Results There were 130 premature infants with gestational ages of 28 to 36 weeks and birth weight of 1 200 to 3 440 g, including 79 male infants, and there were 80 infants in the low-risk group and 50 infants in the high-risk group. The full-term infants had a gestational age of 37 to 42 weeks, and birth weights of 2 500 to 4 000 g, including 162 male infants. There were significant differences in height (Wald χ2=28.664, P<0.001) and head circumference growth (Wald χ2=19.312, P=0.013) among the three groups as revealed by the generalized estimating equation; however, no significant differences were seen in the 12-month weight (F=0.639, P=0.528), height (F=1.051, P=0.350) or head circumference (F=0.318, P=0.728) among the three groups. The percentages of abnormal MDI were 2.00%, 0 and 1.31% among the high-risk premature infants, low-risk premature infants and full-term infants at ages of 12 months (χ2=1.319, P=0.517), while the percentages of abnormal PDI were 20.00%, 7.50% and 5.56% among the three groups at ages of 12 months (χ2=12.818, P=0.002). Conclusions Following implementation of early comprehensive interventions, the premature infants have favorable physical growth and comparable MDI with full-term infants; however, a high percentage of abnormal PDI is seen in high-risk premature infants. An improvement in the motor development among high-risk premature infants is recommended to be emphasized during the management of premature infants.
Key wordspremature infant    early comprehensive intervention    physical growth    mental development index    motor development index
收稿日期: 2022-04-25      修回日期: 2022-06-16      出版日期: 2022-08-10
中图分类号:  R722.6  
基金资助:浙江省医药卫生科技计划项目(2021ZH049); 浙江省公益技术应用研究项目(LGF19H260007)
作者简介: 余红,本科,主任医师,主要从事儿童保健工作
通信作者: 余红,E-mail:sxyuh@126.com   
引用本文:   
余红, 陈晓霞, 吴长划, 沈沛. 早产儿体格生长和神经发育的早期综合干预效果评价[J]. 预防医学, 2022, 34(8): 771-775.
YU Hong, CHEN Xiaoxia, WU Changhua, SHEN Pei. Effect of early comprehensive interventions on physical growth and nervedevelopment among premature infants. Preventive Medicine, 2022, 34(8): 771-775.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2022.08.004      或      http://www.zjyfyxzz.com/CN/Y2022/V34/I8/771
[1] 吴长划.钟菲. 2007—2018年绍兴市新生儿早产趋势分析[J].预防医学,2020,32(2):135-138.
WU C H,ZHONG F.Trend of premature birth in Shaoxing from 2007 to 2018[J].Prev Med,2020,32(2):135-138.
[2] BURNETT A C,ANDERSON P J,LEE K J,et a1.Trends in executive functioning in extremely preterm children across 3 birth eras[J/OL].Pediatrics,2018,141(1)[2022-06-16].https://doi.org/10.1542/peds.2017-1958.
[3] 刘琳玉,张轶勋,李秋菊,等.早产儿纠正胎龄年龄1岁时体格和神经心理发育及其发育商的影响因素[J].广西医学,2020,42(6):690-693.
LIU L Y,ZHANG Y X,LI Q J,et al.Physical/neuropsychological development and influencing factors of developmental quotient in preterm infants with corrected gestational age at one year[J].Guangxi Med,2020,42(6):690-693.
[4] 何丹. 超早期干预对早产儿智能和体格发育的影响[J].中华妇幼临床医学杂志(电子版),2012,8(1):54-56.
HE D.Influence of ultra-early intervention on the physical and intellectual development of premature infants[J].Chin J Obstet Gynecol Pediatr(Electron Ed),2012,8(1):54-56.
[5] 陈小冰,张雪梅,谢邦贵,等.个案管理规范化随访模式对早产儿营养状态、体格智能发育的影响[J].中国医药导报:2019,16(6):77-81.
CHEN X B,ZHANG X M,XIE B G,et al.Effect of standardized follow-up of case management on nutritional status and physical development of premature infants[J]. China Med Her,2019,16(6):77-81.
[6] 张庆丽. 儿童保健对早产儿体格发育及发育商影响的效果观察[J].当代医学,2021,27(19):122-123.
ZHANG Q L.Effect of child health care on physical development and development quotient of premature infants[J].Contemp Med,2021,27(19):122-123.
[7] 中华人民共和国国家卫生和计划生育委员会办公厅.早产儿保健工作规范[J].中华围产医学杂志,2017,20(6):401-406.
Office of the National Health and Family Planning Commission of the People's Republic of China.Premature infant health care standards[J]. Chin J Perinatal Med,2017,20(6):401-406.
[8] 陈荣华,赵正言.儿童保健学[M].5版.南京:江苏凤凰科学技术出版社,2017:11-13.
CHEN R H,ZHAO Z Y.Child Health Care[M].5th ed.Nanjing:Jiangsu Fenghuang Science and Technology Press,2017:11-13.
[9] 《中华儿科杂志》编辑委员会,中华医学会儿科学分会儿童保健学组,中华医学会儿科学分会新生儿学组.早产、低出生体重儿出院后喂养建议[J].中华儿科杂志,2016,54(1):6-12.
[10] 《中华儿科杂志》编辑委员会,中华医学会儿科学分会儿童保健学组,全国佝偻病防治科研协作组.维生素D缺乏性佝偻病防治建议[J].中国实用乡村医生杂志,2011,18(3):5-6.
[11] 易受蓉,罗学荣,杨志伟,等.贝利婴幼儿发展量表在我国的修订(城市版)[J].中国临床心理学杂志,1993,1(2):71-75.
YI S R,LUO X R,YANG Z W,et al.The revising of the Bayley Scales of Infant Development (BSID) in China[J].Chin J Clin Psychol,1993,1(2):71-75.
[12] 张勇,李燕晖,梁静,等.低出生体重早产儿1岁内体格追赶生长的纵向研究[J].中国妇幼健康研究,2020,31(4):413-417.
ZHANG Y,LI Y H,LIANG J,et al.A longitudinal study on catch-up physical growth of low birth weight preterm infants aged 1 year[J].Chin J Woman Child Health Res,2020,31(4):413-417.
[13] 章莹莹,李菁,盛王涛,等.早产儿追赶性生长随访资料回顾性分析[J].中国儿童保健杂志,2018,28(6):684-688.
ZHANG Y Y,LI J,SHENG W T,et al.Retrospective analysis of catch-up growth in 247 premature infants[J].Chin J Child Health Care,2018,28(6):684-688.
[14] 龙吟芸,姚宏智,刘晖,等.早产儿出院后2年体格发育监测与分析[J].中国医师杂志,2018,20(12):1852-1854.
LONG Y Y,YAO H Z,LIU H,et al.Surveillance and analysis of physical development of premature infants two years after discharge[J].Chin J Physicians,2018,20(12):1852-1854.
[15] 周玉润,林颖,孙建乐,等.温州市3 625例早产儿体格生长状况分析[J].预防医学,2017,29(7):740-744.
ZHOU Y R,LIN Y,SUN J L,et al.Physical development status in 3 625 premature infants in Wenzhou City[J].Prev Med,2017,29(7):740-744.
[16] 刘杨,刘环.成都地区早产儿2岁内追赶生长的随访研究[J].中国儿童保健杂志,2021,29(3):243-247.
LIU Y,LIU H.Follow-up study on catch-up growth of premature infants within 2 years old in Chengdu area[J].Chin J Child Health Care,2021,29(3):243-247.
[17] 黄海燕,陆岸锋,黄国盛,等.新型随访模式下早干预对早产儿神经发育的影响[J].中华妇幼临床医学杂志(电子版),2018,14(3):331-336.
HUANG H Y,LU A F,HUANG G S,et al.Influences of early intervention with new follow-up pattern on the neurodevelopment of preterm infants[J].Chin J Obstet Gynecol Pediatr(Electron Ed),2018,14(3):331-336.
[18] 孙燕,张瑜平,贾文智,等.早期干预对早产儿认知发育的影响[J].中国妇幼健康研究,2019,30(3):275-278.
SUN Y,ZHANG Y P,JIA W Z,et al.Influence of early intervention on cognitive development of early and late preterm infants[J].Chin J Woman Child Health Res,2019,30(3):275-278.
[19] 政晓果,李瑞莉,金春华,等.3岁以下儿童精细动作发育情况的影响因素分析[J].中国妇幼保健,2018,33(23):5562-5564.
ZHENG X G,LI R L,JIN C H,et al.Analysis of influencing factors on fine motor development of children under 3 years old[J].Matern Child Health Care China,2018,33(23):5562-5564.
[1] 张艳丽, 朱鹏, 杨蓉, 王鑫鑫, 尹晓光. 早产儿呼吸窘迫综合征肺表面活性物质治疗两种给药方法比较[J]. 预防医学, 2023, 35(9): 757-761.
[2] 门光国, 鲁徐丹, 王丽丽. 初乳对早产儿免疫球蛋白A水平影响的Meta分析[J]. 预防医学, 2023, 35(5): 431-435,439.
[3] 余红, 吴长划, 姚雪, 陈晓霞. 不同喂养方式的6月龄婴儿体格生长和营养状况比较[J]. 预防医学, 2021, 33(6): 636-638.
[4] 李如霞, 王楸, 曹肃婷, 张昌静. 早产儿维生素D水平及影响因素分析[J]. 预防医学, 2019, 31(8): 848-850.
[5] 雷宗峰, 周玉润, 韩影, 孙建乐, 闫洪涛, 杨新军. 孕期温度暴露与早产儿发生的关联性研究[J]. 预防医学, 2019, 31(6): 631-633,636.
[6] 陆斌, 徐春思, 任艳红, 冯佳, 史彩平. 早产与足月出生近视幼儿眼球生物学测量结果比较[J]. 预防医学, 2019, 31(3): 309-310,313.
[7] 朱艳可, 孙媛媛, 缪克凡, 王楸. 早产儿支气管肺发育不良影响因素分析[J]. 预防医学, 2019, 31(10): 1051-1053.
[8] 周玉润, 林颖, 孙建乐, 陈洋. 温州市3 625例早产儿体格生长状况分析[J]. 预防医学, 2017, 29(7): 740-743,747.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed