早产儿矫正年龄2岁时神经发育结局的影响因素

Influential factors of neurodevelopmental outcomes of premature infants corrected gestationalage at 2 years of age

目的探讨早产儿矫正年龄2岁时神经发育结局的风险因素,为尽早干预、降低早产儿不良结局提供依据。方法选择2018年1月1日—2019年1月1日在新疆医科大学第一附属医院早产儿门诊随访矫正年龄达2岁的249例早产儿为研究对象,收集其孕母分娩前资料、新生儿出生时情况、新生儿出生后疾病状态及出院后神经行为干预和随访情况,使用Gesell发育量表评估早产儿神经系统发育状况,回顾分析Gesell评分状况与产前、产时、产后及出院后定期随访神经行为干预有关可能的危险因素。结果249例早产儿在矫正年龄2岁时完成了Gesell评分,204例发育商(Devolpment Quotient,DQ)≥75分,45例DQ<75分。发育正常组与发育异常组随访次数差异具有统计学意义(P<0.05),但两组孕母分娩前的疾病状态、新生儿出生时情况、新生儿出生后疾病状态等因素差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,胎龄与随访次数是影响早产儿矫正年龄2岁时神经发育指数的独立危险因素(P=0.010,OR=1.478)(P=0.028,OR=2.589)。结论早期神经行为干预及定期随访对改善早产儿矫正年龄2岁时的神经发育结局具有重要意义。

Objective To investigate the risk factors of neurodevelopmental outcomes in preterm infants corrected gestationalage at the age of 2 and provide a basis for early intervention and the reduction of adverse outcomes in preterm infants.Methods A total of 249 premature infants assessed at 2 years of age were included in this study,followed in the outpatient clinic of the premature infants of the First Affiliated Hospital of Xinjiang Medical University from January 1st,2018 to January 1st,2019.The current situation,the postnatal disease state of the newborn and the neurobehavioral intervention after discharge and the follow-up situation,the Gesell development scale was used to evaluate the neurological development of premature infants,and the Gesell score and the possible risk factors associated with neurobehavioral interventions during prenatal,prenatal,postnatal,periodic follow-up of postdischarge were reviewed and analyzed.Results All preterm infants completed Gesell assessment at the age of 2.The Devolpment Quotient(DQ)of preterm infants was greater than or equal to 75,and that of 45 preterm infants was less than 75.There were significant differences in the number of follow-ups between the normal development group and the abnormal development group(P<0.05);factors such as the disease state of the pregnant mother before childbirth,the condition of the newborn at birth,and the post-natal disease state of the neonatal normal development group and the abnormal group the difference was not statistically significant(P>0.05).The results of multivariate logistic regression analysis showed that gestational age(P=0.010,OR=1.478)and follow-up times(P=0.028,OR=2.589)were independent risk factors that affected the preterm infants’corrected gestational age at the age of 2.Conclusion Early neurobehavioral intervention and regular follow-up are of great significance in improving the neurodevelopmental outcome of the premature infants at the age of 2 years of corrected gestational age.