IUGR对早产儿早期体格发育和神经发育的影响

Effect of IUGR on early physical growth and neurodevelopment of premature infants

目的分析宫内发育迟缓(IUGR)早产儿出生后校正胎龄过程中生长迟缓及早期神经发育情况。方法选取2018年1月至6月在上海市长宁区妇幼保健院出生的IUGR早产儿56例(研究组)和早产适于胎龄儿78例(对照组)作为研究对象。两组早产儿均进行纠正胎龄处理,情况稳定后行出院指导,并定期到院做相关检查。比较两组新生儿出生后校正胎龄过程中生长迟缓和早期神经发育情况的差异。结果研究组住院时间为(39.96±7.24)d,明显长于对照组(29.47±7.14)d,差异有统计学意义(t=8.34,P<0.01)。研究组出院时和校正胎龄第3、6个月时身长生长迟缓率均明显高于对照组(χ2值分别为17.22、8.68、5.53,均P<0.05),出院时和校正胎龄第3、6个月时体质量生长迟缓率均明显高于对照组(χ2值分别为17.11、12.98、8.45,均P<0.05)。研究组校正胎龄3个月时精细动作、大运动、适应性、社交及语言发育商较对照组明显下降(t值分别为4.04、3.90、4.80、4.63、2.26,均P<0.05)。研究组校正胎龄6个月时语言和精细动作发育商较对照组明显下降(t值分别为3.20、3.11,均P<0.05),而两组社交、适应性及大运动发育商比较,差异均无统计学意义(t值分别为1.75、1.69、1.91,均P>0.05)。结论 IUGR在一定程度上不仅影响早产儿出生后校正胎龄过程中的生长迟缓情况,而且会影响早产儿早期神经发育情况。

Objective To investigate growth retardation rate in preterm infants after correcting gestational age and early neurodevelopment of the preterm infants with intrauterine growth restriction(IUGR).Methods 56 IUGR preterm infants(study group) and 78 preterm infants appropriate for gestational age(AGA)(control group) who gave a birth in Changning District Maternity and Child Health Hospital of Shanghai from January to June,2018 were selected as study subjects.The gestational age of all preterm infants was corrected.After the conditions of the preterm infants were stable,they could discharge and post-hospital guides were given to their parents,and they were asked to receive regular reexamination in the hospital.The differences in growth retardation rate and early neural development between the two groups were compared.Results The hospitalization time of the IUGR preterm infants in the study group was 39.96±7.24 days,which was significantly longer than that of the preterm infants in the control group(29.47±7.14) days(t=8.34,P<0.01).The body length growth retardation rate in the study group at discharge and at the third and the sixth month of the corrected gestational age was significantly higher than that in the control group(χ~2=17.22,8.68 and 5.53 respectively,all P<0.05),and the body weight growth retardation rate at discharge and at the third and the sixth month of the corrected gestational age was significantly higher than that in the control group as well(χ~2=17.11,12.98 and 8.45 respectively,all P<0.05).The development quotients in fine motor,gross motor,adaptability,sociability and language of the IUGR preterm infants in the study group at 3 months of the corrected gestational age were significantly lower than those in the control group(t=4.04,3.90,4.80,4.63 and 2.26 respectively,all P<0.05).Compared with the control group,at 6 months of the corrected gestational age,the developmental quotients in language and fine motor of the IUGR preterm infants in the study group were significantly lower(t=3.20 and 3.11 respectively,both P<0.05),but in development quotients in sociability,adaptability and gross motor there were no significant differences between the two groups(t =1.75,1.69 and 1.91 respectively,all P>0.05).Conclusion IUGR can not only affect the growth retardation condition of the preterm infants in process of correcting the gestational age after birth,but also affect their early neural development at some extent.