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新生儿重症监护对晚期早产儿的影响:3 岁时的发育结果。

Impact of neonatal intensive care on late preterm infants: developmental outcomes at 3 years.

机构信息

School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Rd, Belfast BT9 7BL, UK.

出版信息

Pediatrics. 2012 Nov;130(5):e1105-12. doi: 10.1542/peds.2012-0745. Epub 2012 Oct 1.

Abstract

BACKGROUND

Late preterm infants (LPIs) (34-36 weeks' gestation) account for up to 75% of preterm births and constitute a significant proportion of all neonatal admissions. This study assessed the impact of neonatal intensive or high-dependency care (IC) on developmental outcomes of LPIs at 3 years of age.

METHODS

This cohort study included 225 children born late preterm in Northern Ireland during 2006. Children born late preterm who received IC were compared with children born late preterm who did not receive IC. Cognitive, motor, and language skills were assessed by using the Bayley Scales of Infant and Toddler Development, Third Edition. Growth was assessed by using anthropometric measures of height and weight.

RESULTS

LPIs who received IC were more often less mature (34 weeks' gestation), with lower birth weight (≤ 2500 g) and Apgar scores (<7 at 5 minutes) compared with the control group. They were more often born by cesarean delivery and more likely to have received resuscitation at birth. At 3 years of age, children born late preterm who received IC demonstrated similar cognitive, motor, and language skills compared with children in the control group. Measurements of growth also did not differ significantly between groups.

CONCLUSIONS

Despite having increased maternal, perinatal, and neonatal risk factors, there were no significant differences in early childhood development between LPIs who received IC and those who did not. LPIs do not receive routine follow-up after IC and this study provides useful and reassuring data for parents and clinicians on the longer-term outcome of this infant group.

摘要

背景

晚期早产儿(LPIs)(34-36 周妊娠)占早产儿的比例高达 75%,构成了所有新生儿入院的重要比例。本研究评估了新生儿重症监护或高依赖护理(IC)对 3 岁 LPIs 发育结果的影响。

方法

这是一项在北爱尔兰进行的队列研究,纳入了 2006 年期间出生的 225 名晚期早产儿。接受 IC 的晚期早产儿与未接受 IC 的晚期早产儿进行比较。采用贝利婴幼儿发育量表第三版评估认知、运动和语言技能。通过身高和体重的人体测量指标评估生长情况。

结果

与对照组相比,接受 IC 的 LPIs 往往更不成熟(34 周妊娠),出生体重更低(≤2500g),阿普加评分(5 分钟时<7)较低。他们更常通过剖宫产分娩,并且更有可能在出生时接受复苏。在 3 岁时,接受 IC 的晚期早产儿的认知、运动和语言技能与对照组的儿童相似。两组之间的生长测量值也没有显著差异。

结论

尽管 LPIs 存在更多的母体、围产期和新生儿危险因素,但接受和未接受 IC 的 LPIs 在幼儿期发育方面没有显著差异。LPIs 在接受 IC 后不会常规进行随访,本研究为家长和临床医生提供了有关该婴儿群体长期结果的有用和令人安心的数据。

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