Cheng Wang, Zhao Yan, Liu Chuan, Fan Qiongli, Wang Chengju, Hu Quanjie, Shen Yali, Wu Zhifeng, Yang Wang, Zhang Yuping
Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing, China.
Department of Pediatrics, The General Hospital of Western Theater Command of PLA, Chengdu, China.
Transl Pediatr. 2024 Nov 30;13(11):1913-1922. doi: 10.21037/tp-24-243. Epub 2024 Nov 20.
Corrected age entails determining the age of premature infants by adjusting their gestational age to 40 weeks. Research on corrected age in relation to neurodevelopment is limited, both domestically and internationally, resulting in a lack of consensus and recommendations regarding the appropriate termination of the neurodevelopmental corrected age. This study aimed to assess the neurodevelopmental catch-up status of premature infants with varying gestational ages and to identify appropriate termination criteria for the corrected age of neurodevelopment.
The study included 1,579 premature infants without high-risk factors and 8,441 full-term infants receiving care at the child health clinics of the Second Affiliated Hospital of Army Medical University, Chongqing Health Center for Women and Children, and Maternal and Child Health Care Hospital of Wanzhou District, Chongqing between January 1, 2018, and March 1, 2023. Infants were grouped based on gestational age into early, middle, and late premature infants, as well as full-term infants. Over a 48-month period, the developmental quotient (DQ) of each functional area on the Gesell Developmental Scale was compared across groups.
There were no statistically significant differences in DQ of all functional areas between late premature infants and full-term infants at 36 months of age (all P>0.05). In contrast, some developmental functional areas in middle- and early-premature infants and full-term infants exhibited significant differences at 36 months of age; however, by 48 months of age, these differences were no longer significant (all P>0.05). The DQ of all functional areas in the late, middle, and early premature infant groups demonstrated a catch-up trend from 6 to 48 months of chronological age (all P<0.05).
The termination age for neurodevelopmental correction in premature infants may continue beyond 36 months of age, with longer correction time required for those born at younger gestational ages.
矫正年龄是指通过将早产儿的胎龄调整至40周来确定其年龄。国内外关于矫正年龄与神经发育关系的研究有限，导致在神经发育矫正年龄的适当终止方面缺乏共识和建议。本研究旨在评估不同胎龄早产儿的神经发育追赶状况，并确定神经发育矫正年龄的合适终止标准。
本研究纳入了2018年1月1日至2023年3月1日期间在陆军军医大学第二附属医院、重庆市妇幼保健院儿童健康门诊及重庆市万州区妇幼保健院接受护理的1579例无高危因素的早产儿和8441例足月儿。根据胎龄将婴儿分为早、中、晚期早产儿以及足月儿。在48个月的时间里，比较了各 Gesell 发育量表功能区的发育商（DQ）。
晚期早产儿和足月儿在36月龄时各功能区的DQ无统计学差异（均P>0.05）。相比之下，中期和早期早产儿与足月儿的一些发育功能区在36月龄时存在显著差异；然而，到48月龄时，这些差异不再显著（均P>0.05）。晚期、中期和早期早产儿组各功能区的DQ在实际年龄6至48个月呈现追赶趋势（均P<0.05）。
早产儿神经发育矫正的终止年龄可能持续超过36月龄，胎龄越小的婴儿所需的矫正时间越长。
