Ahn Sung Ho, Kim Soo A
Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Ann Rehabil Med. 2017 Oct;41(5):843-850. doi: 10.5535/arm.2017.41.5.843. Epub 2017 Oct 31.
To assess the well-being of preterm newborns using the Bayley-III scales in a Korean-based population, and to evaluate the perinatal risk factors influencing developmental outcome.
Using the Bayley-III scales, we assessed 120 preterm infants who were referred for evaluation of neurodevelopmental performance. We subdivided them into an extremely preterm group (n=18) and a very/moderate to late preterm group (n=102). Bayley-III mean scores and the rate of infants showing a delay were compared for both groups. The relationship between perinatal risk factors and Bayley-III scores was analyzed. The risk factors were considered as very low birth weight, history of neonatal medical problems, and abnormal radiologic findings in brain magnetic resonance images (MRIs).
Although no significant differences in mean scores were observed between the extremely preterm group and the very/moderate to late preterm group, the rate of babies showing developmental delay in motor composite scores was significantly higher in the extremely preterm group. The proportions of preterm infants with cognitive, language, and motor delays were 38.3%, 26.7%, and 35.0%, respectively. Very low birth weight was a significant risk factor for low cognitive, language, and motor composite scores. Also, abnormal radiologic findings on brain MRI were significant indicators of lower motor composite scores.
Cognitive development was the most frequently delayed domain in preterm infants and motor development was more frequently delayed in the extremely preterm group. The very low birth weight and abnormal radiologic findings in brain MRI were predictive factors for neurodevelopmental outcome.
使用贝利婴幼儿发展量表第三版（Bayley-III）评估韩国人群中早产儿的健康状况，并评估影响发育结局的围产期危险因素。
我们使用贝利婴幼儿发展量表第三版对120名因神经发育表现评估而转诊的早产儿进行了评估。我们将他们分为极早产儿组（n = 18）和极/中度至晚期早产儿组（n = 102）。比较了两组的贝利婴幼儿发展量表第三版平均得分以及发育迟缓婴儿的比例。分析了围产期危险因素与贝利婴幼儿发展量表第三版得分之间的关系。危险因素包括极低出生体重、新生儿疾病史以及脑磁共振成像（MRI）中的异常影像学表现。
尽管极早产儿组与极/中度至晚期早产儿组之间在平均得分上未观察到显著差异，但极早产儿组运动综合得分发育迟缓的婴儿比例显著更高。认知、语言和运动发育迟缓的早产儿比例分别为38.3%、26.7%和35.0%。极低出生体重是认知、语言和运动综合得分低的重要危险因素。此外，脑MRI的异常影像学表现是运动综合得分较低的重要指标。
认知发展是早产儿中最常出现发育迟缓的领域，而运动发展在极早产儿组中更常出现发育迟缓。极低出生体重和脑MRI的异常影像学表现是神经发育结局的预测因素。
