高危儿6岁时智力发育及其影响因素分析

Analysis of mental development of high-risk infants at 6 years old.

【目的】探讨高危儿6岁时智力发育的影响因素及其与早期原始反射和肌张力检查结果的关系,为早期干预提供依据。【方法】本院住院治疗的122例高危儿,12个月进行原始反射、肌张力检查;6岁时采用中国-韦氏儿童智力量表进行检查。【结果】12个月时原始反射及肌张力检查异常为18例(18/105),6岁时智商测定低下或临界共34例(34/107)。影响6岁时智商的独立因素为父母文化程度、早产、新生儿低血糖和5 min Apgar评分。12个月原始反射、肌张力检查异常的儿童6岁时言语、操作及全量表智商均明显低于正常组(P均<0.001)。【结论】父母文化程度低、新生儿低血糖、早产(<32周)5、min Apgar评分低于6分及或12个月时原始反射及肌张力检查异常的儿童应监测其智力发育,以及时予以干预。

[Objective] To investigate the effect of the high-risk and social factors on of age in high-risk infants, and whether the neurologic outcome （primitive reflexes and tone） mental development at 6 years at 12 months was predictive of mental development at 6 years that allow evidence-based intervention planning. [Methods] Subjects included 122 children who had been exposed to high risk factors at and/or after birth. The examination of primitive reflexes and tone was performed at 12 months. And Wechsler Intelligence Scales for Children-Revised for Children （WISC R） was performed at 6 years old. [Results] Abnormal neurologic outcome occurred in 18 （ 17 %） of 105 children at 12 months. At 6 years 34 （32 %） of 107 children were considered mental retardation or borderline intelligence. The independent predictors of delayed mental development were the parent＇s educational level, preterm labor, hypoglycemia of newborn and 5 minute Apgar score. The children with abnormal neurologic outcome at 12 months had significantly lower verbal, performance and fulscale scores of the WISC-R tests at 6 years （P〈0. 001）. [Conclusion] For early intervention, it is necessary to follow up the mental development of the children whose parents had low level of education and/or who experienced premature labor, hypoglycemia of newborn, low 5-minute Apgar score or had abnormal outcome of primitive reflexes and tone at 12 months.