6月龄中度至晚期早产儿的神经发育状况

Tanjina Hoq, P. Chowdhury, Fannana Ahmed, M. Datta, Promugdha Hafiz, R. Das
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摘要

背景:中度早产儿(MP)和晚期早产儿(LP)合计占所有早产婴儿的80%以上。近十年来,人们越来越关注这些婴儿的神经发育异常(NDA)。本研究旨在评估孟加拉国一家三级医院中度至晚期早产新生儿的神经发育状况,并确定与不良神经发育结果相关的因素。材料和方法:在这项前瞻性观察研究中,从2018年6月至2019年5月吉大港医学院附属医院新生儿特护病房(SCANU)招募了215名早产儿(出生时妊娠32至<37周)(107名MP和108名LP)。在矫正年龄(CA) 1、3、6个月时采用快速神经发育评估(RNDA)进行神经发育评估。结果:215例入组儿童中,63例(29.3%)参加了全部3次随访,123例(57.2%)随访不完全或失访,29例(13.5%)死亡。在最后的随访中,63名婴儿中有43名(68.3%)在RNDA的所有8个结构域均未出现异常。单域异常7例(11.1%),多域异常13例(20.6%)。以大运动异常最为常见(28.6%),其次为认知(14.3%)、视力(12.7%)和行为(12.7%)。发现胎龄小和出生体重低是中晚期早产儿NDA的独立预测因素。结论:研究表明,NDA在中度至晚期早产儿中持续到CA 6个月。重要的是密切监测神经发育状况,并提供早期干预转诊病例。上海医科大学医学院;期(2);2021年7月;50 - 54页
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Neurodevelopmental Status of Moderate to Late Preterm Infants at 6 Months Corrected Age
Background: Moderate Preterm (MP) and Late Preterm (LP) infants together comprise more than 80% of all prematurely born infants. Since last decade, there has been growing concern about Neurodevelopmental Abnormality (NDA) in these infants. This study was aimed to assess neurodevelopmental status of moderate to late preterm born neonates and to determine factors associated with adverse neurodevelopmental outcome in a tertiary hospital in Bangladesh. Materials and methods: In this prospective observational study 215 preterm (32 to <37 completed weeks gestation at birth) infants (107 MP and 108 LP) were enrolled from the Special Care Neonatal Unit (SCANU) Chittagong Medical College Hospital from June 2018 to May 2019. Neurodevelopmental assessment was done by Rapid Neurodevelopmental Assessment (RNDA) at 1, 3 and 6 months of Corrected Age (CA). Results: Of the 215 enrolled children, 63 (29.3%) attended all the 3 follow-up, 123 (57.2%) had incomplete follow-up or lost and 29 (13.5%) died. At final follow-up out of 63 infants 43 (68.3%) had no abnormality in all 8 domains of RNDA. Seven infants (11.1%) had abnormality in one domain and 13 (20.6%) had abnormality in more than one domain. Gross motor abnormality was most common abnormality (28.6%), followed by cognition (14.3%), vision (12.7%) and behavior (12.7%). Small for gestational age and lower birth weight were found to be independent predictive factors for NDA in moderate to late preterm infants. Conclusion: Study has shown that NDA persist till 6 months of CA in moderate to late preterm infants. It is important to closely monitor the neurodevelopmental status and provide early intervention in referred cases. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 50-54
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