不同出生胎龄早产儿神经发育追赶状况及校正终止年龄探讨

Neurodevelopmental catch-up status and correction termination age in preterm infants of different gestational ages

摘要:

目的 探讨不同出生胎龄早产儿的神经发育追赶状况及校正终止年龄。方法 回顾性收集2018年1月1日—2023年3月1日在陆军军医大学第二附属医院门诊就诊的918例无明显高危因素早产儿的Gesell发育诊断量表的发育商（developmental quotient, DQ）结果，以6 684例足月儿作为对照。按胎龄分为早产儿组（早期、中期、晚期早产儿）和足月儿组，比较实际年龄48个月内各组儿童各能区DQ的差异及变化趋势。结果 早产儿组所有能区DQ在实际6~48月龄均呈现追赶趋势（P<0.05）。晚期早产儿组在实际36月龄时所有能区DQ与足月儿组相比，差异均无统计学意义（P>0.05），中期、早期早产儿组在实际36月龄时多数能区DQ与足月儿组相比，差异有统计学意义（P<0.05），在48月龄时所有能区DQ与足月儿组相比，差异无统计学意义（P>0.05）。结论 早产儿的神经发育校正终止年龄也许应该持续到36月龄以后，且胎龄越小，校正所需时间越长。

Abstract:

Objective To investigate the status of neurodevelopmental catch-up and suitable correction termination age in preterm infants of different gestational ages.Methods A total of 918 preterm infants without significant high-risk factors who attended the outpatient service of the Second Affiliated Hospital of Army Medical University from January 1, 2018 to March 1, 2023 were included. The data on developmental quotient (DQ) in Gesell Developmental Schedule (GDS) were collected, while 6 684 full-term infants were included as controls. According to the gestational age, the infants were divided into preterm groups (early preterm, moderate preterm, and late preterm births) and a full-term group, and these groups were compared in terms of DQ of each functional area and its changing trend with 48 months of chronological age.Results The DQ values of all functional areas showed a catch-up trend from 6 months to 48 months of chronological age in each preterm group (P<0.05). There were no significant differences in the DQ values of all functional areas between the late preterm and full-term groups at the chronological age of 36 months (P>0.05). There were significant differences in the DQ values of most functional areas between the moderately/early preterm groups and the full-term group at the chronological age of 36 months (P<0.05), but no significant differences were found in the DQ values of all functions areas at the chronological age of 48 months (P>0.05).Conclusions The correction termination age for neurodevelopment in preterm infants may need to extend beyond 36 months, and the smaller the gestational age, the longer the time required for correction.