早产儿语言-社会行为发育差异的回顾性研究

A retrospective study of language-social behavior developmental differences in preterm infants

目的探讨早产儿语言-社会行为情况及其影响因素,研究语言-社会行为发育与智能发育之间的关系,为早产儿保健提供指导。方法采用自制的一般情况问卷对125例早产儿开展随访、追踪,直至2岁时,采用盖泽尔发展量表(GDS)进行语言-社会行为及智能发育评估。结果早产儿语言发育正常43例(34.4%),社会行为发育正常40例(32%)。早产儿语言发育商平均为(67.99±25.75),社会行为发育商平均为(67.75±23.98),处于发育低下水平。性别、脑出血病史、定期随访史、康复干预史、家庭干预史在语言、社会行为方面比较差异均无统计学意义(P>0.05)。不同胎儿期安胎史、胎龄、出生体质量在语言、社会行为方面比较差异有统计学意义(P<0.05);且胎儿期反复安胎,胎龄小,出生体质量低,语言及社会行为发育较差。与出生时无中-重度窒息史的患儿相比,出生时有中-重度窒息的患儿存在更多的语言发育异常,比较差异有统计学意义(P<0.05);但在社会行为发育方面比较差异无统计学意义(P>0.05)。语言-社交行为发育落后的同时,早产儿的大运动、精细动作、适应性行为也存在落后,五大能区比较差异并均有统计学意义(P<0.05)。结论多数早产儿存在语言-社会行为发育落后,其同时可能伴有更多的运动和适应行为发育问题;语言-社交行为发育落后的患儿在胎儿期存在反复安胎且胎龄较小、出生体质量更低或有中-重度窒息史。对早产儿的语言-社会行为要及时给予关注,早期发现并早期干预,改善预后。

Objective To explore the language-social behavior of preterm infants and its influencing factors,to study the relationship between language-social behavior development and intellectual development,and to provide guidance for preterm infants’health care.Methods A self-administered general questionnaire was used to follow up 125 preterm infants until the age of 2 years,and Gesell development scale(GDS)was used to assess their language-social behavior and intellectual development.Results Preterm infants had normal language development in 43 cases(34.4%)and normal social behavioral development in 40 cases(32%).The mean language development quotient of preterm infants was(67.99±25.75)and the mean social behavioral development quotient was(67.75±23.98),which was at the low developmental level.There were no significant differences in gender,history of cerebral hemorrhage,regular follow-up,rehabilitation intervention,family intervention and language or social behavior(P>0.05).Infants with different fetal age history,gestational age,and birth weight varied significantly in language and social behavior(P<0.05);and with repeated miscarriage,small gestational age,low birth weight,showed poor language and social behavior development.Compared the children with and without moderate to severe asphyxia at birth,there was statistically significant differences in language development(P<0.05),but in social behavior there was no significant difference(P>0.05).The backward development of language-social behavior was accompanied by backwardness in gross motor,fine motor,and adaptive behavior in preterm infants,and the differences in the five major domains were all present and statistically significant(P<0.05).Conclusions A major of preterm infants have poor language-social behavior development,which may be accompanied by more motor and adaptive behavior development problems;children with poor language-social behavior development have repeated miscarriage prevention at younger gestational ages,lower birth weights,or a history of moderate-to-severe asphyxia during the fetal period.It is important to give timely attention to language-social behavior in preterm infants for early detection and early intervention to improve prognosis.