胎龄小于34周早产儿全身运动质量的相关因素分析

Analysis of factors associated with the quality of general movements in preterm infants with gestational age less than 34 weeks

目的分析影响胎龄小于34周早产儿全身运动(GMs)质量的相关围生期因素,为临床干预提供理论依据。方法收集2017年1月-2019年10月于甘肃省妇幼保健院出生并在儿童保健科随访的胎龄小于34周早产儿病例。扭动运动阶段554例,不安运动阶段318例,采用t检验、χ^(2)检验及多因素Logistic回归分析GMs结果的影响因素。结果多因素Logistic回归分析显示,扭动运动阶段,低出生体重(OR=7.653,95%CI:2.547~22.995)、呼吸暂停(OR=2.556,95%CI:1.254~5.209)、先心病(OR=4.394,95%CI:1.507~12.809)是异常GMs的独立危险因素。不安运动阶段,新生儿窒息(OR=3.802,95%CI:1.338~10.806)、呼吸窘迫(OR=4.507,95%CI:1.563~12.998)是异常GMs的独立危险因素。结论低出生体重、呼吸暂停、先心病、新生儿窒息、呼吸窘迫是影响胎龄小于34周早产儿GMs的独立危险因素,应对有高危因素的低龄早产儿进行及早识别和干预。

Objective To analyze the perinatal factors influencing the quality of general movements(GMs) in preterm infants with gestational age less than 34 weeks, in order to provide theoretical basis for clinical intervention. Methods Preterm infants with gestational age less than 34 weeks were collected, who were born in Gansu Provincial Maternity and Child-Care Hospital during January 2017 to October 2019 and followed up in the Children′s Health Care Department.There were 554 cases in stage of writhing movements and 318 cases in stage of fidget movements.The high-risk factors for the quality of GMs were analyzed by t test, χ^(2)test and multivariate Logistic regression. Results Multivariate Logistic regression analysis showed that in the stage of writhing movements, the factors significantly associated with abnormal GMs results were low birth weight(OR=7.653, 95%CI:2.547-22.995), apnea(OR=2.556, 95%CI:1.254-5.209), congenital heart disease(OR=4.394,95%CI:1.507-12.809).In the stage of fidget movements, neonatal asphyxia(OR=3.802, 95%CI:1.338-10.806)and respiratory distress(OR=4.507,95%CI:1.563-12.998) were risk factors for abnormal GMs results. Conclusions Low birth weight, apnea, congenital heart disease, neonatal asphyxia, and respiratory distress are high-risk factors for abnormal GMs in preterm infants with gestational age less than 34 weeks.Early screening and intervention should be performed to preterm infants with high risk factors.