早产儿贫血的危险因素及贫血对神经心理发育的影响

Analysis of Risk Factors of Anemia in Premature Infants and Its Influence on Neuropsychological Development

目的探讨早产儿在纠正胎龄6月龄时发生贫血的危险因素及贫血对患儿神经心理发育的影响。方法选择2019年3—12月在兰州大学第一医院儿童保健科进行体检的93名纠正胎龄为6个月的早产儿为研究对象。根据纠正胎龄6个月时所测血红蛋白水平分为贫血组(n=50)和非贫血组(n=43),记录两组患儿的一般资料,采用二元Logistic回归分析早产儿发生贫血的危险因素。采用Gesell发育量表评估两组早产儿神经心理发育情况。结果93例早产儿中有50例血红蛋白<116 g/L,贫血发生率为53.8%。贫血组的胎龄、出生体重小于非贫血组[(33.6±2.1)周比(35.5±1.1)周,(1964±418)g比(2474±435)g](P<0.01),新生儿期住院时间长于非贫血组[9(7,26)d比9(5,13)d](P<0.01),贫血组母孕期患病率高于非贫血组[52.0%(26/50)比32.6%(14/43)](P<0.05),新生儿期非感染性呼吸系统疾病发生率高于非贫血组48.0%(24/50)比23.2%(10/43)(P<0.05)。二元Logistic回归分析结果显示,低出生体重、母孕期患病是早产儿在纠正胎龄6月龄时发生贫血的危险因素(P<0.05)。贫血组粗动作、精细动作、适应行为、语言、个人-社会行为的发育商值均低于非贫血组[(78.1±12.1)比(90.1±6.8)、(76.5±13.0)比(89.0±6.8)、(77.1±11.8)比(87.9±8.1)、(79.7±13.6)比(90.4±5.8)、(80.1±12.8)比(90.4±8.2)](P<0.01)。结论低出生体重及母孕期患病是早产儿在纠正胎龄6月龄时发生贫血的高危因素,且贫血会影响患儿的神经心理发育。

Objective To explore the risk factors of anemia in preterm infants with a gestational-corrected age of 6 months,and to study the effect of anemia on the neuropsychological development.Methods A total of 93 preterm infants with a gestational-corrected age of 6 months who were examined in the Department of Children Healthcare in the First Hospital of Lanzhou University from Mar.to Dec.2019,were included in the study.Based on the hemoglobin value measured at the gestational-corrected age of 6 months,they were divided into a non-anemia group(n=43)and an anemia group(n=50).General clinical data of the two groups were recorded,using binary Logistic regression to analyze the high-risk factors of anemia in the premature infants.Gesell development scale was used to evaluate the neuropsychological development of the preterm infants in both groups.Results Among the 93 preterm infants,50 had hemoglobin<116 g/L,and the incidence of anemia was 53.8%.The gestational age and birth weight of the anemia group were smaller than those of the non-anemia group[(33.6±2.1)weeks vs(35.5±1.1)weeks,(1964±418)g vs(2474±435)g](P<0.01)the neonatal hospital stay was longer than that of the non-anemia group[9(7,26)d vs 9(5,13)d](P<0.01),and the gestational maternal morbidity of the anemia group was higher than that in the non-anemia group[52.0%(26/50)vs 32.6%(14/43)](P<0.05),the incidence of non-infectious respiratory diseases in the neonatal period was higher than that in the non-anemia group[48.0%(24/50)vs 23.2%(10/43)](P<0.05).Binary Logistic regression analysis showed that low birth weight and maternal illness were risk factors for premature infants to develop anemia at the gestational-corrected age of 6 months(P<0.05).The development quotient values of coarse movement,fine movement,adaptive behavior,language and personal-social behavior in the anemia group were lower than those in the non-anemia group[(78.1±12.1)vs(90.1±6.8),(76.5±13.0)vs(89.0±6.8),(77.1±11.8)vs(87.9±8.1),(79.7±13.6)vs(90.4±5.8),(80.1±12.8)vs(90.4±8.2)](P<0.01).Conclusion Low birth weight and maternal illness during pregnancy are high-risk factors for premature infants to have anemia at gestational-corrected age of 6 months,and anemia will affect the neuropsychological development of the children.