动态脑功能监测和NBNA评分对妊娠期糖尿病母亲新生儿脑发育的评估价值

aEEG monitoring and NBNA score in the application of dynamic brain function monitoring on neonates with gestational diabetes mellitus mother

目的:研究动态脑功能检测(aEEG)和新生儿神经行为测定(NBNA)评分对妊娠期糖尿病(GDM)母亲新生儿脑发育的评估价值。方法:选取在我院进行分娩的GDM母亲新生儿240例,按照新生儿出生体重分为大于胎龄儿(LGA)组、适于胎龄儿(AGA)组和小于胎龄儿(SGA)组,对三组新生儿均进行aEEG监测和NBNA评分。比较三组新生儿的aEEG异常发生率,记录三组新生儿NBNA评分及异常比例,分析aEEG监测和NBNA评分对新生儿脑发育的诊断一致性。结果:LGA组、AGA组和SGA组aEEG异常发生率差异有统计学意义(P<0.05),其中LGA组aEEG异常发生率显著高于AGA组(P<0.05),SGA组aEEG异常发生率显著高于AGA组(P<0.05)。LGA组、AGA组和SGA组NBNA总分之间比较,差异有统计学意义(P<0.05)。三组在行为能力、一般反应、主动肌张力和原始反射评分中差异有统计学意义(P<0.05),在被动肌张力的评分中,差异无统计学意义(P>0.05)。三组之间NBNA评分异常率经比较,差异有统计学意义(P<0.05)。aEEG异常和NBNA评分异常具有一致性(χ~2=0.298,P>0.05)。结论:针对GDM母亲新生儿,LGA和SGA发生脑功能损伤的风险较大,在临床中应予以重视,同时aEEG监测和NBNA评分均为GDM母亲新生儿脑发育诊断的重要方法,针对两项检测均异常的高危患儿,应及时进行临床干预,以改善预后。

Objective:To study aEEG monitoring and NBNA score in the application of dynamic brain function monitoring on neonates with gestational diabetes mellitus mother. Methods: A total of 240 neonates of GDM mothers were selected according to the birth weight of the newborn, which were divided into the greater than gestational age (LGA) group, the suitable for gestational age (AGA) group and the small for gestational age (SGA) group. aEEG monitoring and NBNA scores were performed in all three groups of newborns.The incidence of aEEG abnormalities in the three groups of neonates was compared. The NBNA scores and abnormal proportions of the three groups were recorded. The consistency of aEEG monitoring and NBNA scores in the diagnosis of neonatal brain development was analyzed. Results:The incidence of aEEG abnormalities in LGA group, AGA group and SGA group was significantly different ( P <0.05). The incidence of aEEG abnormalities in LGA group was significantly higher than that in AGA group ( P <0.05). The incidence of aEEG abnormalities in SGA group was significantly higher than that in AGA group( P <0.05).There was a significant difference in the total scores of NBNA between LGA group, AGA group and SGA group ( P <0.05). There were significant differences in behavioral ability, general response, active muscle tone and original reflex scores among the three groups ( P <0.05). There was no significant difference in the scores of passive muscle tone ( P >0.05).The abnormal rate of NBNA scores between the three groups was compared, and the difference was significant ( P <0.05). aEEG abnormalities and NBNA score abnormalities were consistent (χ^2 =0.298, P >0.05).Conclusion:For GDM mothers neonates, LGA and SGA have a high probability of brain damage, which should be paid attention to in clinical practice. aEEG monitoring and NBNA score are important methods for the diagnosis of neonatal brain development in GDM mothers neonates . High-risk children should be promptly clinically intervened to improve prognosis.