高危儿神经心理发育现状及影响因素分析

Neuropsychological Development Status And Influencing Factors of High-risk Infants

目的了解高危儿神经心理发育现状,分析各能区发育异常的危险因素,对今后高危儿的管理及早期干预工作的开展提供数据支持。方法选取2020年9月至2022年7月在重庆市璧山区妇幼保健院儿童保健科门诊就诊的547例高危儿为研究对象,采用研究者设计的基本信息调查表及Gesell诊断量表对高危儿进行测试检查,每个能区的测试结果以发育商表示。运用Logistics回归分析其神经心理发育的影响因素。结果本研究共调查547名高危儿,入组年龄均为8月龄,适应性、大运动、精细动作、语言、个人社交5个能区的异常率分别为3.7%、11.7%、6.4%、34.2%和11.5%。运用Logistics回归分析发现,母亲分娩年龄≥35岁、脐带扭转打结、早产是高危儿适应性发育异常的危险因素;母亲有抽烟饮酒等不良生活习惯、孕期胆汁淤积、低出生体重、新生儿肺炎是高危儿大运动发育异常的危险因素;男童、早产、低出生体重是高危儿语言发育异常的危险因素;早产是高危儿精细动作及个人社交发育异常的危险因素。结论早产儿和低出生体重儿的神经心理发育需特别关注,母亲分娩年龄、孕期抽烟饮酒等不良生活习惯、孕期胆汁淤积及脐带情况对儿童脑发育也具有显著影响。

Objective:To understand the present situation of neuropsychological development of high-risk infants, analyze the risk factors of abnormal development in various energy areas, and provide data support for the management and early intervention of high-risk infants in the future. Methods:From September 2020 to July 2022, 547 high-risk infants were selected as the research objects, and the basic information questionnaire and Gesell diagnostic scale designed by the researchers were used to test the high-risk infants. The test results of each energy area were expressed by developmental quotient. Logistics regression was used to analyze the influencing factors of neuropsychological development. Results:A total of 547 high-risk infants were investigated, all of whom were 8 months old. The abnormal rates of adaptability、large exercise、fine movements、language and personal communication were 3.7%、11.7%、6.4%、34.2% and 11.5% respectively. Logistics regression analysis showed that the mother's delivery age ≥35 years old、twisted umbilical cord and premature delivery were the risk factors of adaptive dysplasia in high-risk infants. Mother's bad living habits such as smoking and drinking、cholestasis during pregnancy、low birth weight and neonatal pneumonia are the risk factors for abnormal development of high-risk infants. Boys、premature delivery and low birth weight are risk factors for abnormal language development in high-risk infants. Premature delivery is a risk factor for abnormal fine motor and personal social development in high-risk infants. Conclusion:The neuropsychological development of premature infants and low birth weight infants should be paid special attention to. The age of delivery, smoking and drinking habits during pregnancy, cholestasis during pregnancy and umbilical cord condition also have significant effects on children's brain development.