中国儿童保健杂志 ›› 2018, Vol. 26 ›› Issue (7): 705-708.DOI: 10.11852/zgetbjzz2018-26-07-03

• 科研论著 • 上一篇    下一篇

晚期早产儿Dubowitz神经学评估法与发育行为结局的关联性研究

林森然1,2, 李筠1,2, 崔娓1,2, 古桂雄1,2, 花静1   

  1. 1 同济大学附属第一妇婴保健院,上海 201204;
    2 苏州大学附属儿童医院,江苏 苏州 215000;
  • 收稿日期:2017-12-21 发布日期:2018-07-10 出版日期:2018-07-10
  • 通讯作者: 花静,E-mail:szhuaj@hotmail.com;古桂雄,E-mail:szggx000@163.com
  • 作者简介:林森然(1991-),女,山东人,儿科学硕士在读,主要研究方向为儿童保健。
  • 基金资助:
    国家自然科学基金委员会面上项目(81673179);上海市申康医院发展中心适宜技术联合开发推广应用项目(SHDC12016239);上海市公共卫生三年行动计划重点学科人才项目(15GWZK0401)

Research on the association between Dubowitz neurological assessment and the outcome of
developmental behavior in late-preterm infants

LIN Sen-ran1,2, LI Yun1,2, CUI Wei1,2, GU Gui-xiong1,2, HUA Jing1   

  1. 1 Shanghai First Maternity and Infant Hospital,Tongji University School of Medicine,Shanghai 201204,China;
    2 Children's Hospital of Soochow University,Suzhou,Jiangsu 215000,China;
  • Received:2017-12-21 Online:2018-07-10 Published:2018-07-10
  • Contact: HUA Jing,E-mail:szhuaj@hotmail.com; GU Gui-xiong,E-mail:szggx000@163.com

摘要: 目的 初步评价Dubowitz神经学评估法-第2版(The Neurological Assessment of the Preterm and Full-term Newborn Infant-Second Edition)对晚期早产儿发育行为结局的预测效果,为完善晚期早产儿随访体系提供线索。方法 选取2016年10月-2017年3月间在上海市第一妇婴保健院出生的低风险晚期早产儿(34+0~36+6孕周)116例组成随访队列,于超早期(生后6 h内)和矫正“足月”(矫正胎龄40孕周)时分别进行Dubowitz神经学评估,矫正6月龄时进行贝利-Ⅲ诊断测试(Bayley Scale of Infant and Toddler Development-3rd Edition),采用Pearson相关系数分析Dubowitz神经学评估分数与认知、运动发育商之间的相关性。结果 矫正6月龄时,认知发育商与超早期和矫正“足月”异常体征分数相关(r=0.184和-0.187,P均<0.05),与矫正“足月”姿势和肌张力、反射两个维度分数相关(r=0.187和0.182,P均<0.05);运动发育商与超早期姿势和肌张力、异常体征两个维度相关(r=0.201和0.219,P均<0.05)。结论 Dubowitz神经学评估对晚期早产儿的发育行为结局具有一定的预测价值,值得在更大的人群中进一步研究和应用。

关键词: Dubowitz神经学评估法, 发育行为, 相关性, 晚期早产儿

Abstract: Objective To preliminarily examine the predictive validity of the Dubowitz Neurological Assessment-2nd Edition (The Neurological Assessment of the Preterm and Full-term Newborn Infant-second edition) to the outcome of developmental behavior in late-preterm infants,in order to provide basis for improving the follow-up system of late-preterm infants. Methods A total of 116 low-risk late-preterm (34+0~36+6 gestational weeks) infants born in Shanghai First Maternity and Infant Hospital from October 2016 to March 2017 were selected into the follow-up cohort.Dubowitz Neurological Assessment was performed at ultra-early stage (within 6 hours after birth) and at term age (40-week corrected gestational age) respectively.Bayley-Ⅲ (Bayley Scale of Infant Development-3rd Edition) was used to assess developmental outcome at corrected age 6 months .Pearson correlation coefficients were used to analyze the correlation between Dubowitz Neurological Assessment scores and Bayley-Ⅲ cognitive and motor composite scores. Results The cognitive composite scores of corrected age of 6 months were associated with abnormal signs of both ultra-early stage (r=0.184, P<0.05) and term age (r=-0.187, P<0.05),and were related to the scores of posture and tone and reflex(r=0.187,0.182,P<0.05).The motor composite scores were related to posture and tone and abnormal signs (r=0.201,0.219,P<0.05). Conclusion The Dubowitz Neurological Assessment has a certain predictive value for the outcome of developmental behavior of late-preterm infants, and further study is warranted for the application in a larger population.

Key words: Dubowitz neurological assessment, developmental behavior, correlation, late-preterm infants

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