家庭干预对早产儿早期神经心理发育效果研究

Effects of family intervention on early neurodevelopment of premature infants

目的评估家庭干预对早产儿神经心理发育的效果,并探索干预效果的影响因素,为早产儿早期干预提供依据。方法对786名早产儿进行家庭干预并随访,矫正胎龄6月龄时应用Bayley婴幼儿发育量表(BSID-I)对早产儿智力发育和运动发育进行评估,采用巢式病例对照研究,以多因素logistic回归计算干预效果,并根据早产儿的不同特征分层,计算每层中干预作用的大小。结果家庭干预能降低早产儿智力发育异常的风险(OR=0.31,95%CI:0.11~0.84),分层分析结果显示干预对于男性早产儿、晚期早产儿、低出生体重早产儿、母亲年龄<30岁、父亲或母亲受教育程度为高中以上的早产儿效果显著(P<0.05)。家庭干预能降低低出生体重早产儿运动发育运动发育异常的风险(OR=0.24,95%CI:0.07~0.90)。结论家庭干预能促进早产儿的智力发育和低出生体重早产儿的运动发育。早产儿的自身因素和家庭因素都能影响干预的效果。

Objective To evaluate effects of family intervention on early neurodevelopment of premature infants, ex- plore factors of intervention effect,and provide evidences to early intervention for premature infants. Methods A total of 786 premature infants were followed up,Bayley Scales of Infant Development（BSIDq） was used to evaluate their mental de- velopment and motor development at corrected 6 months age. A nested case-control study was carried out by multivariable logistic regression analysis. Premature infants were stratified to analyze intervention effect in each layer. Results Family intervention could reduce the risk of poor mental development of premature infants （OR =0. 31,95% CI： 0. 11 ~ 0.84）, and stratification analysis showed that intervention effect was significant in boys, late premature infants, low birth weight prema- ture infants and premature infants whose mothers＇ age were under thirty or parents＇ education were over high school. Family intervention could reduce the risk of poor motor development in low birth weight premature infants （OR= 0.24,95% CI： 0. 07~0. 90）. Conclusions Family intervention can increase mental development of premature infants and motor develop- ment of low birth weight premature infants. Factors of premature infants and their family can influence intervention effect.