Bao Meng-Yu, Qiao Xiu-Yun, Zhang Xin-Han, Zhang Zi-Xuan, Zhao Fei, Chen Xin-Xia
School of Nursing and Rehabilitation, Shandong University, Jinan 250012, China (Chen X-X, Email: chenxxsdu@ 163. com).
Zhongguo Dang Dai Er Ke Za Zhi. 2023 Dec 15;25(12):1246-1252. doi: 10.7499/j.issn.1008-8830.2307040.
To investigate the level of neuropsychological development in large for gestational age (LGA) infants at the age of 12 months.
The infants, aged 12 to <13 months, who attended the Outpatient Service of Child Care in the First Affiliated Hospital of Shandong First Medical University from December 2021 to June 2023, were enrolled as subjects. According to the gestational age and birth weight, they were divided into preterm appropriate for gestational age (AGA) group, preterm LGA group, early term AGA group, early term LGA group, full-term AGA group, and full-term LGA group. A modified Poisson regression analysis was used to investigate the association between LGA and neuropsychological development outcome at 12 months of age.
After adjustment for confounding factors, compared with the full-term AGA group at the age of 12 months, the full-term LGA group had a significant increase in the risk of language deficit (=1.364, 95%: 1.063-1.750), the early term LGA group had significant increases in the risk of abnormal gross motor, fine motor, language, and the preterm LGA group had significant increases in the risk of abnormal language, social behavior, and total developmental quotient (0.05); also, the early term AGA group had higher risks of developmental delay across all five attributes and in total developmental quotient at the age of 12 months (0.05); except for the language attribute, the preterm AGA group had higher risks of developmental delay in the other 4 attributes (0.05).
The neuropsychological development of LGA infants with different gestational ages lags behind that of full-term AGA infants at 12 months of age, and follow-up and early intervention of such infants should be taken seriously in clinical practice.
探讨大于胎龄儿(LGA)在12月龄时的神经心理发育水平。
选取2021年12月至2023年6月在山东第一医科大学第一附属医院儿童保健门诊就诊的12至<13月龄婴儿作为研究对象。根据胎龄和出生体重,将其分为早产适于胎龄儿(AGA)组、早产LGA组、早期足月AGA组、早期足月LGA组、足月AGA组和足月LGA组。采用改良泊松回归分析探讨LGA与12月龄时神经心理发育结局之间的关联。
在调整混杂因素后,与12月龄的足月AGA组相比,足月LGA组语言缺陷风险显著增加(=1.364,95%:1.063 - 1.750),早期足月LGA组粗大运动、精细运动、语言异常风险显著增加,早产LGA组语言、社会行为及总发育商异常风险显著增加(0.05);此外,早期足月AGA组在12月龄时所有五个属性及总发育商的发育迟缓风险均较高(0.05);除语言属性外,早产AGA组在其他4个属性的发育迟缓风险较高(0.05)。
不同胎龄的LGA婴儿在12月龄时神经心理发育落后于足月AGA婴儿,临床实践中应重视对此类婴儿的随访及早期干预。