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新生儿发病率对晚期早产儿发育迟缓风险的影响。

Impact of neonatal morbidity on the risk of developmental delay in late preterm infants.

作者信息

Martínez-Nadal Sílvia, Demestre Xavier, Schonhaut Luisa, Muñoz Sergio R, Sala Pere

机构信息

Department of Pediatrics, Hospital de Barcelona-SCIAS, Barcelona, Spain.

Department of Pediatrics, Hospital de Barcelona-SCIAS, Barcelona, Spain.

出版信息

Early Hum Dev. 2018 Jan;116:40-46. doi: 10.1016/j.earlhumdev.2017.11.001. Epub 2017 Nov 11.

Abstract

BACKGROUND

Late preterm infants (LPI) have a higher risk of developmental delay (DD) than term-born infants. The association of perinatal complications with specific morbidity is not clear.

AIM

(1) To compare the risk of DD at 4years of age between LPI who have presence or absence of any morbidity associated with the prematurity at birth, called complicated (cLPI) or uncomplicated (uLPI), and term-born infants, (2) to determine maternal and perinatal factors associated with risk of DD, and (3) to analyze, in LPI, the association between perinatal morbidity and risk of DD.

METHODS

A retrospective cohort study including 163 LPI - 47 cLPI and 116 uLPI - and 158 term-born infants (Terms) was conducted. Parents completed the Ages & Stages Questionnaires®3rd Spanish version (ASQ3). Risk of DD was defined as the presence of any ASQ3 domain scoring below the mean minus 2 SD. Association between risk of DD and maternal and perinatal factors was analysed using a multivariate logistic model. Incidence of risk of DD was analysed according to specific morbidity.

RESULTS

Compared to Terms, cLPI have a higher risk of DD in the communication domain. Respiratory pathology was associated with a higher risk in the communication domain. Caesarean delivery was the only maternal perinatal risk factor for DD, especially in gross motor domain.

CONCLUSIONS

At the age of 4years cLPI, especially those with respiratory morbidity, had a higher risk of communication delay. Caesarean delivery was the only perinatal risk factor associated with risk of DD.

摘要

背景

晚期早产儿(LPI)比足月儿发生发育迟缓(DD)的风险更高。围产期并发症与特定疾病的关联尚不清楚。

目的

(1)比较出生时伴有或不伴有任何与早产相关疾病(分别称为复杂型晚期早产儿(cLPI)和非复杂型晚期早产儿(uLPI))的晚期早产儿与足月儿在4岁时发生发育迟缓的风险;(2)确定与发育迟缓风险相关的母体和围产期因素;(3)分析晚期早产儿围产期疾病与发育迟缓风险之间的关联。

方法

进行了一项回顾性队列研究,纳入163例晚期早产儿(47例cLPI和116例uLPI)和158例足月儿。父母完成了《年龄与发育阶段问卷》第3版西班牙语版(ASQ3)。发育迟缓风险定义为任何ASQ3领域得分低于均值减2个标准差。使用多因素逻辑模型分析发育迟缓风险与母体和围产期因素之间的关联。根据特定疾病分析发育迟缓风险的发生率。

结果

与足月儿相比,cLPI在沟通领域发生发育迟缓的风险更高。呼吸系统疾病与沟通领域的较高风险相关。剖宫产是发育迟缓唯一的母体围产期风险因素,尤其是在大运动领域。

结论

4岁时,cLPI尤其是患有呼吸系统疾病的患儿,发生沟通延迟的风险更高。剖宫产是与发育迟缓风险相关的唯一围产期风险因素。

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