Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No.100, Hong Kong Road, Jiang'an District, Wuhan, 430016, China.
BMC Pediatr. 2022 May 5;22(1):251. doi: 10.1186/s12887-022-03312-3.
The incidences of early term and late preterm birth have increased worldwide during recent years. However, there is a lack of prospective study about the influence of early term and late preterm birth on infants' neurodevelopment, especially at the early stage. Therefore, we conducted this cohort study to investigate the impact of early term and late preterm birth on infants' neurodevelopment within 6 months.
This cohort study was conducted in Wuhan, China, between October 2012 and September 2013. A total of 4243 singleton infants born within 34-41 weeks of gestation at Wuhan Children's Hospital were included. The Gesell Developmental Scale (GDS) was utilized to evaluate the neurodevelopment of infants.
Among the 4243 included participants, 155 (3.65%) were late preterm infants, 1288 (30.36%) were early term infants, and 2800 (65.99%) were full term infants. After adjusted for potential confounders, significant negative relationship was shown between late preterm birth and development quotient (DQ) in all domains of neurodevelopment: gross motor (β = - 17.42, 95% CI: - 21.15 to - 13.69), fine motor (β = - 23.61, 95% CI: - 28.52 to - 18.69), adaptability (β = - 10.10, 95% CI: - 13.82 to - 6.38), language (β = - 6.28, 95% CI: - 9.82 to - 2.74) and social behavior (β = - 5.99, 95% CI: - 9.59 to - 2.39). There was a significant negative trend for early term birth in DQ of fine motor (β = - 2.01, 95% CI: - 3.93 to - 0.09). Late preterm infants had a significantly elevated risk of neurodevelopmental delay in domains of gross motor (adjusted OR = 3.82, 95% CI: 2.67 to 5.46), fine motor (adjusted OR = 3.51, 95% CI: 2.47 to 5.01), and adaptability (adjusted OR = 1.60, 95% CI: 1.12 to 2.29), whereas early term birth was significantly associated with neurodevelopmental delay of fine motor (adjusted OR = 1.22, 95% CI: 1.05 to 1.42).
This study suggested that late preterm birth mainly elevated the risk of neurodevelopmental delay of gross motor, fine motor, and adaptability, whereas early term birth was associated with the developmental delay of fine motor within 6 months. Further research is needed to determine the effectiveness and necessity of the interventions at the early stage for early term and late preterm infants who had suspected neurodevelopmental delay.
近年来，全球范围内早期早产和晚期早产的发生率有所增加。然而，缺乏关于早期早产和晚期早产对婴儿神经发育影响的前瞻性研究，特别是在早期阶段。因此，我们进行了这项队列研究，以调查早期早产和晚期早产对婴儿 6 个月内神经发育的影响。
本队列研究在中国武汉进行，时间为 2012 年 10 月至 2013 年 9 月。共纳入武汉儿童医院 34-41 周单胎婴儿 4243 例。采用盖塞尔发展量表（GDS）评估婴儿的神经发育情况。
在纳入的 4243 名参与者中，155 名（3.65%）为晚期早产儿，1288 名（30.36%）为早期早产儿，2800 名（65.99%）为足月儿。调整潜在混杂因素后，晚期早产与所有神经发育领域的发育商（DQ）呈显著负相关：大运动（β=-17.42，95%CI：-21.15 至-13.69）、精细运动（β=-23.61，95%CI：-28.52 至-18.69）、适应能力（β=-10.10，95%CI：-13.82 至-6.38）、语言（β=-6.28，95%CI：-9.82 至-2.74）和社会行为（β=-5.99，95%CI：-9.59 至-2.39）。早期早产与精细运动的 DQ 呈显著负趋势（β=-2.01，95%CI：-3.93 至-0.09）。晚期早产儿在大运动（调整 OR=3.82，95%CI：2.67 至 5.46）、精细运动（调整 OR=3.51，95%CI：2.47 至 5.01）和适应能力（调整 OR=1.60，95%CI：1.12 至 2.29）领域出现神经发育迟缓的风险显著增加，而早期早产与精细运动的神经发育迟缓显著相关（调整 OR=1.22，95%CI：1.05 至 1.42）。
本研究表明，晚期早产主要增加大运动、精细运动和适应能力的神经发育迟缓风险，而早期早产与 6 个月内精细运动的发育迟缓有关。需要进一步研究确定早期干预对有疑似神经发育迟缓的早期和晚期早产儿的有效性和必要性。
