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乌干达两家城市医院中,校正胎龄为6至24个月的早产儿的神经发育迟缓及相关因素。

Neurodevelopmental delay and associated factors among preterm infants aged 6 to 24 months adjusted gestation age in two urban hospitals in Uganda.

作者信息

Nalwoga Joyce, Nakibuuka Victoria, Manirakiza Leonard, Namata Tracy Tushabe, Sebunya Robert

机构信息

Department of Pediatrics, St Francis Nsambya Hospital, Kampala, Uganda.

Consultant Neonatologist, St. Francis Hospital Nsambya, Kampala, Uganda.

出版信息

PLOS Glob Public Health. 2025 May 29;5(5):e0004361. doi: 10.1371/journal.pgph.0004361. eCollection 2025.

Abstract

Neurodevelopmental delay has been reported among preterm infants who survive beyond the neonatal period. However, there is paucity of data regarding neurodevelopmental outcomes in preterm infants in Africa, including Uganda. This study aimed to determine the prevalence and factors associated with neurodevelopment delay (NDD) in preterm infants aged 6-24 months of adjusted gestation age. A cross-sectional study was conducted among 206 preterm infants, aged between 6 and 24 months of adjusted gestation age in the preterm follow up clinics at St. Francis Hospital Nsambya and Mulago Specialized Women and Neonatal Hospital in Kampala-Uganda from 25th January 2021-25th January 2022. The prevalence of NDD was 13.6% (28/206), with social delay comprising 12.1% (25/206), fine motor delay 11.7% (24/206), language delay 10.7% (22/206) and gross motor delay 7.8% (16/206). Significant factors associated with NDD included microcephaly [aPR = 6.2, CI: 2.6-33.5, P < 0.001], severe acute malnutrition (SAM) [aPR = 4.6, CI: 1.87-12.56, P = 0.021], incomplete immunization [aPR = 2.8, CI: 1.23-4.76, P = 0.013], neonatal sepsis [aPR = 3.8, CI: 1.1-9.3, P = 0.026], neonatal hypoglycemia [aPR = 6.2, CI: 1.8-16.4, P = 0.002], lack of caretaker social support [aPR = 8.3, CI: 2.43-37.9, P = 0.002] and large family size (≥5 children) [aPR = 6.8, CI: 2.24-22.7, P = 0.002]. NDD affects 13.6% of preterm infants, with the social and fine motor delays being most prevalent. Modifiable factors like malnutrition, lack of caretaker social support and incomplete immunization should be screened and addressed to reduce NDD among preterm infants in Uganda.

摘要

据报道,在新生儿期后存活的早产儿中存在神经发育迟缓的情况。然而,在包括乌干达在内的非洲,关于早产儿神经发育结局的数据却很匮乏。本研究旨在确定矫正胎龄6至24个月的早产儿中神经发育延迟(NDD)的患病率及相关因素。2021年1月25日至2022年1月25日期间,在乌干达坎帕拉的圣弗朗西斯医院恩桑比亚分院和穆拉戈专科医院的早产儿随访诊所,对206名矫正胎龄在6至24个月的早产儿进行了一项横断面研究。NDD的患病率为13.6%(28/206),其中社交延迟占12.1%(25/206),精细运动延迟占11.7%(24/206),语言延迟占10.7%(22/206),粗大运动延迟占7.8%(16/206)。与NDD相关的显著因素包括小头畸形[aPR = 6.2,CI:2.6 - 33.5,P < 0.001]、重度急性营养不良(SAM)[aPR = 4.6,CI:1.87 - 12.56,P = 0.021]、免疫接种不全[aPR = 2.8,CI:1.23 - 4.76,P = 0.013]、新生儿败血症[aPR = 3.8,CI:1.1 - 9.3,P = 0.026]、新生儿低血糖症[aPR = 6.2,CI:1.8 - 16.4,P = 0.002]、缺乏照顾者的社会支持[aPR = 8.3,CI:2.43 - 37.9,P = 0.002]以及家庭规模较大(≥5个孩子)[aPR = 6.8,CI:2.24 - 22.7,P = 0.002]。NDD影响13.6%的早产儿,其中社交和精细运动延迟最为普遍。应筛查并解决营养不良、缺乏照顾者的社会支持和免疫接种不全等可改变因素,以减少乌干达早产儿中的NDD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff6f/12121762/1a358037d424/pgph.0004361.g001.jpg

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