合并脑损伤高危因素小于胎龄儿的生后早期运动发育特点
Early motor development in small for gestational age infants at high risk of brain injury
简茹 1张慧平 2卜婧愉 3袁飒 4陈艳妮1
作者信息
- 1. 西安交通大学医学部,西安 710061;西安交通大学附属儿童医院(西安市儿童医院)新生儿重症医学科,西安 710002
- 2. 西安交通大学附属儿童医院(西安市儿童医院)新生儿重症医学科,西安 710002
- 3. 西安交通大学医学部,西安 710061;空军军医大学唐都医院儿科,西安 710038
- 4. 西安交通大学医学部,西安 710061;三二〇一医院儿童保健科,汉中 723000
- 折叠
摘要
目的 探讨合并脑损伤高危因素的小于胎龄儿的早期运动发育特点.方法 回顾性纳入2022年2～10月在西安市儿童医院新生儿随访门诊随访,合并脑损伤高危因素且在校正年龄(corrected age,CA)2～5周或CA14～17周随访并完成一次婴儿运动能力测试(Test of Infant Motor Performanc,TIMP)的小于胎龄儿(small for gestational age,SGA)和适于胎龄 儿(appropriate for gestational age,AGA)共 81 例.CA2～5 周随访到 SGA 17例(SGA组),AGA 24例(AGA组);CA14～17周随访到SGA 20例(SGA组),AGA 20例(AGA组).采用两独立样本t检验、秩和检验及x2检验比较组间的人口学特征、脑损伤高危因素及TIMP各项评分的差异.结果 CA2～5周和CA14～17周,SGA组的出生体重均低于AGA组[(1 817.1±440.3)与(2 630.0±560.9)g,t=-4.98;(1 752.0± 434.4)与(2 226.3±699.8)g,t=-2.58;P值均＜0.05],但2组的出生胎龄、脑损伤高危因素差异均无统计学意义(P值均＞0.05).(1)CA2～5 周:SGA组 TIMP 原始总分[(71.6±13.7)与(80.5±11.5)分,t=-2.26,P=0.029]、引出项评分[61.0 分(41.0～85.0 分)与 69.1 分(49.0～96.0 分),Z=-2.15,P=0.037]和坐位[8.8 分(3.0～19.0 分)与 11.2 分(5.0～22.0 分),Z=-2.07,P=0.038]、俯卧位评分[(9.8±3.1)与(12.3± 3.1)分,t=-2.19,P=0.034]均低于AGA组.(2)CA14～17周:SGA组患儿的TIMP站立位评分低于AGA组[6.5分(4.0～11.0分)与7.7分(2.0～11.0分),Z=-2.05,P=0.040],但原始总分及坐位、仰卧位、俯卧位、翻身、侧方位各体位评分组间差异均无统计学意义(P值均＞0.05).结论 5月龄前,SGA的早期运动能力较AGA低,在CA2～5周主要表现为头控能力相对落后,在CA14～17周时头控能力落后延续至站立位.
Abstract
Objective To investigate the characteristics of early motor development in small for gestational age(SGA)infants at high risk of brain injury.Methods This study retrospectively enrolled a total of 81 SGA infants and appropriate for gestational age(AGA)infants who were at high risk of brain injury and attended outpatient follow-up visits in Xi'an Children's Hospital from February to October 2022.Seventeen SGA infants(SGA group)and 24 AGA infants(AGA group)were assessed for motor development using the Test of Infant Motor Performance(TIMP)at 2-5 weeks of corrected age(CA)and 20 SGA infants(SGA group)and 20 AGA infants(AGA group)were assessed at 14-17 weeks of CA.Independent samples t-test,rank-sum test,and Chi-square test were used to compare the demographic characteristics,high-risk factors of brain injury,and TIMP scores between the two groups.Results At 2-5 weeks and 14-17 weeks of CA,the birth weights of SGA group were both less than those of AGA group[(1 817.1±440.3)vs.(2 630.0±560.9)g,t=-4.98;(1 752.0±434.4)vs.(2 226.3±699.8)g,t=-2.58;both P＜0.05],but there were no significant differences in gestational age at birth or high-risk factors of brain injury between the two groups(all P＞0.05).(1)At 2-5 weeks of CA:SGA group had lower total TIMP score[(71.6±13.7)vs.(80.5±11.5)scores,t=-2.26,P=0.029],elicited item score[61.0 scores(41.0-85.0 scores)vs.69.1 scores(49.0-96.0 scores),Z=-2.15,P=0.037],sitting position score[8.8 scores(3.0-19.0 scores)vs.11.2 scores(5.0-22.0 scores),Z=-2.07,P=0.038],and prone position score[(9.8±3.1)vs.(12.3±3.1)scores,t=-2.19,P=0.034]when compared with AGA group.(2)At 14-17 weeks of CA:The standing position score of the SGA group was lower than that of the AGA group[6.5 scores(4.0-11.0 scores)vs.7.7 scores(2.0-11.0 scores),Z=-2.05,P=0.040],but no statistical difference was observed in the total TIMP score or the scores of sitting,supine,prone,turning,and lateral positions between the two groups(all P＞0.05).Conclusion Early motor performance of SGA infants is inferior to AGA infants before five months of age,which is embodied in the poor head control at 2-5 weeks of CA that further affects the stability of standing posture in them at 14-17 weeks of CA.
关键词
脑损伤/婴儿,小于胎龄/胎儿生长迟缓/神经发育障碍/运动技能Key words
Brain injuries/Infant,small for gestational age/Fetal growth retardation/Neurodevelopmental disorders/Motor skills引用本文复制引用
基金项目
国家自然科学基金(81371900)
陕西省重点研发计划(2020GXLH-Y-013)
陕西省重点研发计划(2021SF-194)
陕西省科学技术研究发展计划(213ST2-09)
西安市科技计划项目(20YXYJ00064)
陕西中医药大学中西医结合防治脑发育障碍性疾病创新团队(2019-YL07)
上海申康医院发展中心临床三年行动计划(SHDC2020CR1047B)
Xi'an Science and Technology Plan Project(20YXYJ00064)
出版年
2024
NETL
NSTL
维普
万方数据