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不同孕周范围内婴儿的早期神经发育

Early Life Neurodevelopment of Infants Across a Wide Gestational Age Range.

作者信息

Chan Peggy H Y, Lai C M, Lam H S, Wong Patrick C M

机构信息

Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China.

Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong SAR, China.

出版信息

J Dev Behav Pediatr. 2025 Aug 22. doi: 10.1097/DBP.0000000000001411.

Abstract

OBJECTIVE

Neural development differs between in-utero and ex-utero environments. Length of gestational age (GA) is associated with brain development and early life neurodevelopmental outcomes, affecting both preterm and term infants. This study aimed to examine a wide range of GA and provide a more comprehensive understanding of its effects on various developmental domains.

METHOD

Four hundred fifty-four infants who were born at 24 to 41 weeks of GA were included in this analysis. Cognitive, language, and motor development between 8 and 30 months of age were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Associations between GA and outcomes were analyzed using linear and logistic mixed-effects models.

RESULTS

GA was positively associated with all examined developmental domains with a small-sized effect (Pearson's correlation coefficients: 0.08-0.15; p < 0.05). After adjusting for covariates, linear mixed-effect models estimated that each additional week of GA was associated with an increase in Bayley III composite scores: cognitive (0.6 points), language (0.6 points), and motor (0.62 points). Logistic mixed-effect models showed that after adjusting for the covariates, each additional week of GA reduced the adjusted odds ratio of delay in 1 of the language subdomains (i.e., receptive communication) by 13%.

CONCLUSION

We found a small impact of GA on cognitive, language, and motor development across a wide range of GA. Language and its subdomains seem particularly sensitive to the effects of prematurity. Thus, regular monitoring and parent-based early intervention, especially in the language domain, are warranted for early-term and preterm infants.

摘要

目的

子宫内和子宫外环境中的神经发育有所不同。胎龄(GA)的长短与大脑发育及早期神经发育结局相关,对早产儿和足月儿均有影响。本研究旨在考察广泛的胎龄范围,并更全面地了解其对各个发育领域的影响。

方法

本分析纳入了454名胎龄在24至41周出生的婴儿。使用贝利婴幼儿发展量表第三版(Bayley-III)评估8至30个月大时的认知、语言和运动发育情况。使用线性和逻辑混合效应模型分析胎龄与结局之间的关联。

结果

胎龄与所有考察的发育领域均呈正相关,效应量较小(皮尔逊相关系数:0.08 - 0.15;p < 0.05)。在调整协变量后,线性混合效应模型估计,胎龄每增加一周,贝利III综合得分就会增加:认知(0.6分)、语言(0.6分)和运动(0.62分)。逻辑混合效应模型显示,在调整协变量后,胎龄每增加一周,语言子领域之一(即接受性沟通)延迟的调整比值比降低13%。

结论

我们发现胎龄对广泛胎龄范围内的认知、语言和运动发育影响较小。语言及其子领域似乎对早产的影响尤为敏感。因此,对于早期足月儿和早产儿,有必要进行定期监测和以家长为基础的早期干预,尤其是在语言领域。

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