标题：晚期早产儿早期神经系统发育情况及其影响因素

      作者：龙芳 1，邹静静 1，钟迪 1，陈露雨 2    广东省妇幼保健院新生儿科 1、内科 2，广东 广州 510010

      卷次： 2019年30卷12期

      【摘要】 目的 探讨晚期早产儿早期神经系统发育情况及其影响因素。方法 选取广东省妇幼保健院产科2015年6月至2016年5月出生的150例晚期早产儿为研究对象(晚期组)，通过多种因素配对后，选取同期150例足月儿作为对照(足月组)。于晚期早产儿矫正胎龄40周、6个月龄以及1周岁时三个时间点对两组儿童进行智能测试，比较晚期组和足月组智能发育水平。根据上述智能测试结果将晚期组分为发育正常组和发育异常组，分析影响神经系统发育的危险因素。结果 晚期组和足月组在矫正胎龄40周、6个月龄和1周岁纳入随访者分别为150例、142例、135例和150例、127例、115例；6个月龄晚期组早产儿大运动明显落后于足月儿，1周岁时大运动、精细运动和语言均落后于足月儿，差异均有统计学意义(P<0.05)；多因素分析结果显示，小于胎龄、低血糖、Apgar评分、败血症、新生儿呼吸窘迫综合征和父母文化程度低是影响晚期早产儿早期发育的危险因素(P<0.05)。结论 晚期早产儿早期神经系统发育落后于足月儿，小于胎龄、新生儿呼吸窘迫综合征、低血糖、Apgar评分、败血症和父母文化程度低是影响晚期早产儿早期神经系统发育的危险因素。
      【关键词】 晚期早产儿；足月儿；神经系统发育；危险因素；干预措施
      【中图分类号】 R722 【文献标识码】 A 【文章编号】 1003—6350（2019）12—1551—03

Early neurological development analysis in late preterm infants and its influencing factors.
LONG Fang 1, ZOUJing-jing 1, ZHONG Di 1, CHEN Lu-yu 2. Department of Neonatology 1, Department of Internal Medicine 2, GuangdongMaternal and Child Health Hospital, Guangzhou 510010, Guangdong, CHINA
【Abstract】 Objective To explore the early development of nervous system in late preterm infants and its influ-encing factors. Methods A total of 150 late preterm infants born in the Department of Obstetrics, Guangdong Maternaland Child Health Hospital from June 2015 to May 2016 were selected as subjects (late group), and, after pairing with var-ious factors, 150 full-term children were selected as controls (full-term group). Intelligent tests were performed in thetwo groups at 40 weeks, 6 months and 1 year of corrected age, and the intelligence development levels of the late groupand the full-term group was compared. According to the above intelligent test results, the late group were further dividedinto the normal development group and the dysplastic group, and the risk factors affecting the development of the ner-vous system were analyzed. Results A total of 150, 142, 135 late preterm infants were assessed at 40 weeks, 6 monthsand 1 year of corrected age, respectively. Meanwhile, 150, 127 and 115 full-term infants were also evaluated in the corre-sponding time. At corrected age of 6 months, the development of gross motor skills in the late group were lagging behindtheir peers of full-term birth; at corrected age of 1 year, the development of gross motor skills, fine motor skills, and lan-guage skills in late preterm infants remain lagging behind full-term infants, and the differences were both statistically sig-nificant (P<0.05). Multivariate analysis showed that less than gestational age, hypoglycemia, Apgar score, sepsis, neona-tal respiratory distress syndrome, and low parental education were risk factors for early development of the nervous sys-tem in late preterm infants (P<0.05). Conclusion In the early stage of late preterm infants, the development of the ner-vous system lags behind full-term children. Less than gestational age, neonatal respiratory distress syndrome, hypoglyce-mia, Apgar score, sepsis, and low parental education are risk factors for the development of early advanced nervous sys-tem in late preterm infants.
      【Key words】 Late preterm infant; Full-term infant; Nervous system development; Risk factors; Intervention