Child Health Care Department, Shenzhen Longgang District Maternity and Child Health Care Hospital, Shenzhen 518172, Guangdong, China.
Child Health Care Department, Shenzhen Longgang Central Hospital, Shenzhen 518100, Guangdong, China.
J Healthc Eng. 2022 Apr 13;2022:7496785. doi: 10.1155/2022/7496785. eCollection 2022.
The tissues and organs of premature infants are immature and easily damaged by external adverse factors, leading to functional development disorders and abnormalities. Besides, the incidence of premature babies in various countries has an increasing trend, with the incidence rate exceeding 10%.
This study aims to investigate the neurodevelopment and the incidence of various developmental delays, cerebral palsy, autism spectrum disorder, and audio-visual impairment in premature infants under 34 weeks of gestation from birth to 2 years of age, so as to provide the basis for early intervention of premature infants in the clinic.
A cohort of premature infants was established using 263 premature infants with a gestational age of 28-33 + 6 weeks who were born alive from March 1, 2018, to February 28, 2019, in four tertiary hospitals in Shenzhen. In addition, 263 full-term infants of the same sex who were born in the same period in the four hospitals were randomly selected and paired in a ratio of 1 : 1 as the control group. The subjects were assessed for neurodevelopment using the Gesell test scale at 6, 12, 18, and 24 months after birth (premature infants were corrected for months). We calculated the neurodevelopmental indicators of children in each month of age and the incidence of various developmental delays, cerebral palsy, autism spectrum disorder, and audio-visual impairment in the two groups.
The results of this study showed that the cohort of premature infants with birth gestational age less than 34 weeks had higher adaptive, fine motor, and personal-social energy domain development quotient (DQ) values from the corrected gestational age of 6 months to the corrected gestational age of 24 months after birth compared with the full-term cohort. And it also achieved catch-up growth in neurological development, but the detection rates of neurodevelopmental abnormalities at the corrected gestational age of 12 and 24 months were higher than those in the full-term cohort.
It is important to reduce the disability rate and degree of premature infants by strengthening the systematic management, early promotion and supervision, as well as early intervention for preterm infants with developmental abnormalities who were born at gestational age less than 34 weeks after birth.
早产儿的组织和器官不成熟，容易受到外界不良因素的损害，导致功能发育障碍和异常。此外，各国早产儿的发病率呈上升趋势，发病率超过 10%。
本研究旨在探讨胎龄 28-33+6 周早产儿从出生到 2 岁时的神经发育及各种发育迟缓、脑瘫、自闭症谱系障碍和视听障碍的发生率，为临床早产儿的早期干预提供依据。
采用队列研究方法，选取 2018 年 3 月 1 日至 2019 年 2 月 28 日在深圳市 4 家三甲医院出生的胎龄 28-33+6 周、存活的 263 例早产儿为研究对象，另选取同期在这 4 家医院出生的 263 例同性别足月儿作为对照组，1:1 配对。采用盖塞尔发育量表对两组儿童生后 6、12、18、24 个月（早产儿校正月龄）进行神经发育评估，计算各月龄儿童的神经发育指标及两组各种发育迟缓、脑瘫、自闭症谱系障碍和视听障碍的发生率。
本研究队列中胎龄＜34 周的早产儿，从校正胎龄 6 个月到校正胎龄 24 个月后，适应性、精细运动和个人-社会能量领域的发育商（DQ）值均高于足月儿队列；且在神经发育方面实现了追赶性生长，但校正胎龄 12、24 个月时神经发育异常的检出率高于足月儿队列。
加强对胎龄＜34 周早产儿的系统管理、早期促进和监督，以及对有发育异常的早产儿进行早期干预，对降低早产儿的残疾率和残疾程度具有重要意义。
