不同胎龄早产儿1岁时体格和神经发育差异分析

Comparison of differences of physique and neurodevelopment in early preterm infants and late preterm infants at 1 year of age

目的探讨不同胎龄早产儿1岁时体格发育和神经发育的差异。方法随访年龄达到1岁的早产儿,分为早期早产儿(EPI)组(胎龄<34周)和晚期早产儿(LPI)组(34周≤胎龄<37周),比较两组体重和身长发育的差异、体重和身长增长迟缓发生率,以及运动发育指数(PDI)、智力发育指数(MDI)和精神运动发育的差异。结果 EPI组68例,LPI组106例。1岁时两组体重差异无统计学意义(P>0.05),EPI组身长低于LPI组[(74.1±2.2)cm比(75.9±2.9)cm,P<0.05)],身长增长迟缓发生率高于LPI组(26.5%比7.4%,P<0.05)。校正年龄6个月和1岁时两组MDI差异无统计学意义(P>0.05),EPI组PDI低于LPI组[(77.7±9.4)分比(86.6±11.4)分,(81.0±12.1)分比(88.2±11.5)分,P均<0.05)]。脑性瘫痪EPI组2例,LPI组3例。结论 1岁时EPI身长和运动发育较LPI明显延迟,应重视不同胎龄早产儿的出院后干预。

Objective The study aims to compare physical development and neurodevelopment between early preterm infants （EPI） and late preterm infants （LPI） at 1 year of age. Methods Preterm infants are grouped into EPI and LPI with following up for one year. Differences in their body weight, body length, rate of growth retardation （ ≤ P10）, psychomotor development index （PDI）, mental development index （MDI） and neurophysical development are compared. Results Totally 68 cases of EPI and 106 cases of LPI were studied. The body length of EPI are shorter than the LPI （P 〈 0.05） in body length and The incidence of developmental retardation in body length were higher in the EPI group than that in LPI group （P 〈 0.05 ） at 1 year of age, but no significant difference for weight （P 〉 0. 05 ） There was no difference in MDI between the two groups at 6 months and 1 year of age （P 〉 0. 05） , but PDI of EPI are lower than that of LPI （P 〈 0. 05）. We found 2 cases cerebral palsy in EPI group and 3 cases in EPI group. Conclusions Our data suggest that the length and physical development of EPI are significantly delayed compared with LPI at 1 year age, therefore priorities should be given to the early intervention of various preterm infants upon discharge.