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正常范围内的孕期时长能否预测婴儿神经运动发育?

Does gestational duration within the normal range predict infant neuromotor development?

作者信息

van Batenburg-Eddes Tamara, de Groot Laila, Arends Lidia, de Vries Alies, Moll Henriette A, Steegers Eric A P, Hofman Albert, Jaddoe Vincent W V, Verhulst Frank C, Tiemeier Henning

机构信息

The Generation R Study Group, Erasmus Medical Center Rotterdam, The Netherlands.

出版信息

Early Hum Dev. 2008 Oct;84(10):659-65. doi: 10.1016/j.earlhumdev.2008.04.007. Epub 2008 Jun 11.

Abstract

AIM

To examine the extent to which infant neuromotor development is determined by gestational duration and birth weight within the normal range.

METHODS

The study was embedded within the Generation R Study, a population-based cohort in Rotterdam, the Netherlands. An adapted version of Touwen's Neurodevelopmental Examination was used to assess 3224 infants (1576 males and 1648 females) at corrected ages between 9 and 15 weeks. Non-optimal neuromotor development was defined as a score in the highest tertile.

RESULTS

Infant neuromotor development was significantly affected by gestational duration (odds ratio 0.8, 95% confidence interval 0.7;0.8). Adding a quadratic term of gestational duration to the model revealed a highly significant curvilinear association between gestational duration and neuromotor development; after adjusting for post-conceptional age this was still significant. Although babies with a 1 kg lower birth weight had a 30% higher risk of non-optimal neuromotor development, this association disappeared after adjustment for post-conceptional age.

CONCLUSIONS

Our findings indicate that differences in infant neuromotor development can be explained even by variations in gestational duration within the normal range. If an infant is found to have minor neuromotor delays, account should be taken of this.

摘要

目的

研究在正常范围内,婴儿神经运动发育受孕周和出生体重的影响程度。

方法

本研究纳入了荷兰鹿特丹一项基于人群的队列研究——Generation R研究。采用改编版的图恩神经发育检查法,对3224名婴儿(1576名男婴和1648名女婴)在矫正年龄9至15周时进行评估。非最佳神经运动发育被定义为得分处于最高三分位数。

结果

婴儿神经运动发育受孕周显著影响(比值比0.8,95%置信区间0.7;0.8)。在模型中加入孕周的二次项后,显示孕周与神经运动发育之间存在高度显著的曲线关联;在校正孕龄后,这种关联仍然显著。尽管出生体重低1千克的婴儿出现非最佳神经运动发育的风险高30%,但在校正孕龄后,这种关联消失了。

结论

我们的研究结果表明,即使在正常范围内,孕周的差异也能解释婴儿神经运动发育的差异。如果发现婴儿有轻微的神经运动延迟,应予以考虑。

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