影响婴儿全身运动质量的高危因素

High-risk factors for quality of general movements in infants

目的婴儿全身运动(GMs)质量评估技术是预测婴儿脑功能异常的有价值的工具,该研究旨在探讨影响婴儿GMs质量的高危因素。方法分别选取618例扭动运动阶段和539例不安运动阶段婴儿进行GMs评估。采用单因素方差分析、卡方检验及多因素logistic回归分析调查影响婴儿GMs质量的高危因素。结果扭动运动阶段,多因素logistic回归分析显示有统计学意义的影响因素为出生胎龄(OR=0.762,P<0.001)、出生体重(OR=0.264,P<0.001)、重度窒息(OR=2.445,P=0.012)、宫内窘迫(OR=4.865,P<0.001)。不安运动阶段,多因素logistic回归分析显示有统计学意义的影响因素为出生胎龄(OR=0.786,P=0.003)、出生体重(OR=0.217,P<0.001)、重度窒息(OR=3.765,P=0.001)、高胆红素血症(OR=2.640,P=0.028)。结论出生胎龄、出生体重、重度窒息、宫内窘迫、高胆红素血症是异常GMs的高危因素,应早期筛查、干预。

Objective To investigate the high-risk factors for the quality of general movements（GMs）, which has a predictive value for brain dysfunction in infants. Methods A total of 618 infants in the stage of writhing movements and 539 infants in the stage of fidgety movements were selected separately for the evaluation of GMs. The high-risk factors for the quality of GMs in infants were analyzed by ANOVA, chi-square test, and multivariate logistic regression. Results Multivariate logistic regression analysis showed that the factors significantly associated with the quality of GMs in the stage of writhing movements were gestational age（OR=0.762, P〈0.001）, birth weight（OR=0.264, P〈0.001）, severe asphyxia（OR=2.445, P=0.012）, and intrauterine distress（OR=4.865, P〈0.001）; the factors significantly associated with the quality of GMs in the stage of fidget movements were gestational age（OR=0.786, P=0.003）, birth weight（OR=0.217, P〈0.001）, severe asphyxia（OR=3.765, P=0.001）, and hyperbilirubinemia（OR=2.640, P=0.028）. Conclusions Low gestational age, low birth weight, severe asphyxia, hyperbilirubinemia and intrauterine distress are high-risk factors for abnormal GMs in infants, and early screening and intervention should be performed to reduce the incidence of abnormal nervous system sequelae.