绒毛膜羊膜炎暴露的小于34周早产儿婴儿期体格及神经发育的观察

Observation of physical and neurological development in infancy of premature infants of gestational age less than 34 weeks and with exposure to chorioamnionitis

目的分析绒毛膜羊膜炎(CA)对小于34周早产儿在婴儿期体格及神经发育的影响。方法收集在青岛市妇女儿童医院NICU住院且出院后随访至纠正年龄12个月的小于34周早产儿共78例,根据胎盘病理有无CA,分为CA组(A组)早产儿41例、非CA组(B组)早产儿37例,随机抽取同时期在我院儿童保健科健康查体的足月儿33例(C组),分析比较三组婴儿期的体格生长指标﹑智力发育指数(MDI)﹑运动发育指数(PDI)及神经运动发育的差异。结果 1)纠正年龄6月龄时A、B组体重及身长发育落后于C组,纠正年龄12月龄时B组身长发育落后于C组,差异有统计学意义(P<0.05)。2)纠正年龄6月龄时A组MDI、PDI得分低于B、C组,差异有统计学意义(P<0.05);纠正年龄12月龄时三组婴儿MDI、PDI得分比较,差异无统计学意义(P>0.05)。纠正年龄6、12月龄时A、B两组早产儿20项神经运动检查异常发生率均高于C组,差异有统计学意义(P<0.05)。结论绒毛膜羊膜炎暴露的小于34周的早产儿在婴儿期发生体格及精神运动发育落后的可能性大。

Objective To investigate the effect of chorioamnionitis on physical and neurological development in infancy of premature infants with gestational age less than 34 weeks. Methods A total of 41 premature infants with exposure to chorioamnionitis （group A） and 37 premature infants without exposure to chorioamnionitis （group B） of gestational age less than 34 weeks followed up for 12 months after discharge from Qingdao Women and Children＇s Hospital were enrolled in this study. 33 mature healthy infants （group C） were randomly selected from the department of child healthcare. Differences of physical growth indexes, mental development index（MDI）,motor development index（ PDI） and neural motor development in infancy of the three groups were compared. Results 1）The weight and length development of group A and group B lagged behind those of group C at corrected age of 6 month （P〈0.05）. The length development of group B lagged behind that of group C at corrected age of 12 months （P〈0.05）. 2）The MDI,PDI in group A were lower than those in group B and group C at corrected age of 6 month （P〈0.05） ;There was no significant difference in MDI, PDI among three groups at corrected age of 12 month（P〈0.05）. The incidence of abnormal results in the 20 items of neuromotor assessment in group A and group B was high er than that in group C at corrected age of 6 months and 12 months （P〉0.05）. Conclusion Premature infants with gestational age less than 34 weeks exposed to chorioamnionitis are more likely to develop physical and mental retardation in infancy.