早产儿早期神经心理发育的影响因素研究

Factors influencing the early neurodevelopment in premature infants

目的探讨早产儿神经心理发育情况及其影响因素,为早产儿保健提供指导。方法对859例早产儿进行定期随访和早期家庭干预,矫正6月龄时应用贝利婴幼儿发育量表(bayley scales of infant development,BSID-I)进行评估,采用多元线性回归模型进行影响因素分析。结果早产儿矫正6月龄智力和运动发育迟缓率分别为2.4%和3.4%。出生体重≥2 000 g、家庭月收入5 000元及以上、前六个月纯母乳喂养者,智力发育较好(均有P<0.05);家庭月收入5 000元及以上、前六个月纯母乳喂养、完成早期家庭干预者,运动发育较好(均有P<0.05)。多元线性回归模型结果显示,智力发育与前六个月纯母乳喂养(β=2.827,95%CI:0.348~5.305)、较高出生体重(β=4.030,95%CI:1.351~6.710)和较高家庭月收入(β=2.909,95%CI:0.352~5.465)呈正相关;运动发育与完成早期家庭干预(β=2.331,95%CI:0.146~4.516)和较高家庭月收入(β=2.848,95%CI:0.156~5.541)呈正相关。结论前六个月纯母乳喂养和早期家庭干预能够促进早产儿神经心理发育,建议更加关注低出生体重和家庭收入较低的早产儿的神经心理发育。

Objective To assess early neurodevelopment of premature infants and explore its influencing factors and provide guidance on health care for premature infants. Methods A total of 859 premature infants were followed up and given early comprehensive intervention. Barley scales of infant development （BSID-I） was used to evaluate their men- tal and motor development. Multivariable linear regression analysis was used to explore influencing factors of mental and motor development. Results At the corrected age of 6 months, the growth retardation rate of mental and motor development was 2. 4% and 3.4%, respectively. Premature infants with birth weight ≥2 000 g, monthly household income ≥ 5 000 yuan and breast-feeding within the first 6 months had better mental development （ all P 〈 0. 05 ） ; and those with monthly household income ≥5 000 yuan, breast-feeding within the first 6 months and with completed early family intervention had better motor development （ all P 〈 0. 05 ）. Muhivariable linear regression analysis showed that mental development was positively correlated with breast-feeding within the first 6 months （ β = 2. 827, 95% CI：0. 348-5. 305 ）, higher birth weight （ β = 4. 030, 95 % CI： 1.351-6. 710） and higher monthly household income （ β =2. 909, 95 % CI： 0. 352-5. 465 ） ; and mental development was positively correlated with completed early family intervention （ β = 2. 331, 95% CI： 0. 146- 4. 516） and higher monthly household income （ β = 2. 848, 95% CI：0. 156-5. 541 ）. Conclusions Breast-feeding within 6 months and early family intervention could promote neurodevelopment of premature infants. Thus, more attention should be paid to premature infants with lower birth weight and lower household income.