胎龄<34周呼吸窘迫综合征早产儿1岁时神经心理发育的随访研究

Neuropsychological development at the age of 1 year in preterm infants <34 weeks with respiratory distress syndrome:a follow-up study

目的 探讨新生儿呼吸窘迫综合征(RDS)对早产儿1岁时神经心理发育的影响。方法 选取2016年1月至2019年12月在本院产科分娩,生后收治NICU住院治疗,且出院后定期在高危儿门诊随访满1年的240例早产儿作为研究对象,根据早产儿在新生儿期是否合并RDS分为RDS组99例和非RDS组141例。采用Gesell发育量表评估两组早产儿纠正胎龄1岁时神经心理发育状况及差异。结果 RDS组早产儿在纠正胎龄1岁时适应性、大运动、精细动作、个人社交发育商(DQ)均落后于非RDS组早产儿,差异有统计学意义(P<0.05),语言发育DQ差异无统计学意义(P>0.05);RDS组早产儿5个能区DQ异常发生率(DQ<85分)均明显高于非RDS组早产儿,差异有统计学意义(P<0.05);采用多因素Logistic回归分析矫正相关影响因素后发现,与非RDS组早产儿相比,RDS组早产儿适应和语言DQ异常风险更高,OR值分别为0.460和0.743,差异有统计学意义(P<0.05)。结论 RDS早产儿在1岁时神经心理发育水平落后于非RDS早产儿,且神经发育异常风险增高,临床应重视RDS早产儿出院后随访保健,早期干预。

Objective To investigate the influence of respiratory distress syndrome(RDS) on the neuropsychological development of preterm infants at the age of 1 year.Methods A total of 240 preterm infants who were born in our hospital from Jan.2016 to Dec.2019 hospitalized in the NICU and followed up for one year after discharge in the high-risk infant clinic were selected as the study subjects.According to the diagnosis,the preterm infants were divided into the RDS group(n=99) and the non-RDS group(n=141),and the neuropsychological development of preterm infants at corrected gestational age of 1 year were evaluated by the Gesell Scale.Results At the corrected gestational age of 1 year,the DQ of adaptability,great motor ability,fine motor ability and personal social ability of RDS preterm infants was behind that of non-RDS preterm infants,and the difference was statistically significant(P0.05).The abnormal DQ rates(DQ<85 points) in the five energy regions of RDS preterm infants were significantly higher than those of non-RDS preterm infants,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis was used to correct the relevant influencing factors,and it was found that compared with non-RDS preterm infants,RDS preterm infants had a higher risk of abnormal development of adaptive ability and language ability(OR=0.460/0.734,P<0.05).Conclusion The neuropsychological development of RDS preterm infants falls behind that of non-RDS preterm infants at the age of 1 year,and the rate of neurodevelopmental abnormality is increased.Clinical attention should be paid to the follow-up care and early intervention of RDS preterm infants.