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极低出生体重早产儿0~1岁生长发育纵向随访研究

A follow-up on first-year growth and development of very low birth weight preterm infants

  • 摘要: 目的 探讨极低出生体重(very low birth weight, VLBW)早产儿生后第一年体格发育和神经心理发育规律,为促进生长发育和改善发育预后提供科学依据。方法 选取2017年1月—2019年1月苏州市立医院儿童保健科定期随访并建立专案管理,符合入组条件且随访资料完整的108例VLBW早产儿作为观察组,同期随机抽取187例健康足月儿作为对照组。定期测量体格发育指标,采用WHO Anthro软件计算生后(纠正)1、3、6、12月龄的体重、身长和头围Z评分,并采用《0~6岁儿童神经心理发育量表》对其神经心理发育水平进行评价。通过重复测量资料方差分析比较组间和组内生长发育指标情况。结果 (1)VLBW早产儿体重和头围在纠正6月龄内Z评分呈上升趋势,但在纠正6~12月龄Z评分上升不明显;身长在纠正12月龄内Z评分呈不断上升趋势。(2)在纠正1~6月龄,两组间体重Z评分相近,但在纠正12月龄,VLBW早产儿组体重Z评分落后于足月组(P=0.017)。在纠正3~12月龄,两组间身长Z评分和头围Z评分相近。(3)在纠正1岁时,其大运动、精细运动、社交发育水平达到足月儿组(P> 0.05),但适应能力和语言水平仍不及足月儿组(P<0.05)。结论 VLBW早产儿在纠正0~1岁内体格发育呈追赶趋势,呈先快后慢模式,且神经心理发育水平各能区发育存在不均衡性。

     

    Abstract: Objective To investigate the physical growth and psychomotor development of very low birth weight(VLBW) preterm infants in the first year, in order to provide scientific basis for promoting growth and improving development prognosis. Methods A total of 108 VLBW preterm infants who were managed by the project of Children's Health Center of the Affiliated Suzhou Hospital of Nanjing Medical University from January 2017 to January 2019 were enrolled in this study, Meanwhile, 187 full-term infants were randomly selected as the control group. Weight, length and head circumference of the infants were regularly measured at corrected age of 1, 3, 6, 12 months old and WHO Anthro software was used to calculate the Z-scores of the weight, length and head circumference.The neuropsychological development examination table for children aged 0-6 years old was used to evaluate the neuropsychological development level of all the infants. The growth indicators of premature and full-term infants were compared by repeated measures analysis of variance. Results (1) The weight and head circumference of VLBW preterm infants showed an upward trend in Z score within corrected age of 6 months old, but the increase was not obvious at the corrected age of 6 to 12 months old. The length showed an upward trend in Z score within the corrected age of 12 months old.(2) The Z score of weight was similar between the two groups at corrected age of 1 to 6 months old. However, at correction age of 12 months old, the Z scores of weight in the VLBWI premature infant group were lower than that in the full-term group(P= 0. 017). The Z scores of length and head circumference were similar between the two groups at corrected age of 3 to 12 months old.(3) At the corrected age of 12 months old, there were no significant differences on gross motor, fine motor and personal-social level between the two groups(P> 0. 05). However, the level of adaptability and language development of VLBWI premature infants was still lower than that of the control group(P< 0. 05). Conclusion VLBWI preterm infants have catch-up growth in physical development within the corrected age of 12 months old, with the speed of the catch-up growth going quickly at first and then slowing down. And there are imbalances indevelopment dimensions.

     

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