低体重儿的认知和运动发育特点

Characteristics of cognition and exercise development in neonates with low birth weight

目的:分析出生低体重儿的认知发育特点及其影响因素。方法:采用自制的家庭一般环境问卷、Bayley婴幼儿发育量表对50例出生低体重儿和50例出生正常体重儿15～30个月时的认知发育及其家庭环境进行调查。出生低体重儿组为2002-06/2004-03青岛大学医学院儿童保健门诊就诊患儿,出生正常体重儿组为随机抽取的市区幼儿园入园儿童。两组性别、年龄、家庭一般环境状况匹配。从自制的家庭一般环境问卷(家长用)获取胎龄,出生体质量,孕期病史,分娩方式,家庭结构,家庭经济收入,父母文化程度等相关信息。以Baylay婴幼儿发育量表中国城市修订版作为婴幼儿认知发育的研究工具,包括智力量表、运动量表2个部分。分别用智力发展指数和运动发展指数表示。结果:在调查过程中,两组儿童数据均进入结果分析。①出生低体重儿组智力发展指数、运动发育指数显著低于出生正常体重儿,差异有显著性意义犤(97.36±20.21),(106.32±12.71),t=2.70,P<0.01犦;犤(99.84±16.36),(104.86±7.48),t=1.99,P<0.05犦。②出生低体重儿智力发育偏离或异常的几率明显比出生正常体重儿增高(9/18,1/2,χ2=7.111,P=0.008);运动发育差异无显著性意义(3/6,1/2,χ2=1.042,P=0.307)。③出生低体重儿运动发育优秀比例比出生正常体重儿明显降低(2/4,8/16,χ2=4.000,P=0.046);智力发育优秀的比例差异不显著(5/10,8/16,χ2=0.796,P=0.372)。④单因素相关分析和多元逐步回归分析显示,智力发展指数随着家庭经济收入的增高而增高;运动发育指数与分娩方式有关,顺产儿运动发育指数更好。结论:出生低体重儿的智力发展指数、运动发育指数显著低于出生正常体重儿,智力发展指数、运动发育指数分别与家庭经济收入、分娩方式有关。

AIM： To analyze the feature of cognitive developments in children with low birth weight （LBW） and its influential factors. METHODS： Cognitive development and family environment were examined in 50 LBW children and 50 normal birth weight （NBW） children aged 15-30 months with self-made questionnaire of influential factors and Bayley scales of infant development. Children patients from Children Health Care Out-patient Clinic of Medical School of Qingdao University from June 2002 to March 2004 were in the LBW group. Children in the NBW group were randomly selected from city kindergarten. Their sex, age and general family environment were matched in the two groups. Gestational age, birth weight, pregnant history, delivery, family structure, income of family, parents education could be gathered from self-made questionnaire of influential factors （used by＇ parents）. The Bayley scales of infant development （China revised edition） was adopted as research tool of cognitive development of infants, including intelligence scale and exercises scale that were expressed with intelligent development index and exercises development index, respectively. RESULTS： The data in the investigation of all the children in the two groups were involved in the result analysis.①Intelligent development index and exercises development index in the LBW group were lower signiflcandy than that in the NBW group, which had significant difference [（97.36±20.21）, （106.32±12.71）, t=2.70, P 〈 0.01]; [（99.84±16.36）, （104.86±7.48）, t=1.99,P 〈 0.05].②The rate of abnormal intelligent development in LBW children was markedly higher than that of NBW children （9/18,1/2,X^2=7.111 ,P=0.008）. There was no significant difference in the exercise development （3/6,1/2,X^2=1.042,P=-0.307）.③The excellent development proportion in the LBW children decreased remarkably than the NBW children （2/4,8/16,X^2=4.000,P=0.046）. There was no significant difference in the excellent intelligent development （5/10,8/16,X^2=0.796,P =0.372）. ④The single factor correlation analysis and multiple stepwise regression analysis showed that the intelligent development index increased with the increase of family income; Exercises development index was associated with delivery, and the exercise development was better in the natural labor children. CONCLUSION： The intelligent development index and exercises development index in LBW children are lower markedly than those in NBW children. The intelligent development index and exercises development index are associated with family income and delivery, respectively.