早产儿生后1岁体格及神经追赶发育研究

Research on the Physical and Neurodevelopmental Catch-Up Growth in Preterm Infants within the First Postnatal Year

摘要: 目的：分析总结1岁前早产儿的临床特点、体格及神经追赶发育情况，为早产儿发育提供干预提供参考依据。方法：回顾性分析安徽医科大学附属省儿童医院2023年12月至2024年12月收治的60例早产儿的住院及随访资料。采用描述性统计分析。根据早产儿出生体重和胎龄，将早产儿分为早产小于胎龄儿(Small for gestational age, SGA)组(15例)和早产适于胎龄儿(Appropriate for gestational age, AGA)组(45例)。所有患儿均接受随访至矫正年龄12个月，比较两组早产儿在身长和体重追赶性生长、生长迟缓发生率以及运动、精神发育指标方面的差异。结果：60例早产儿中，男35例(58.33%)，女25例(41.67%)。出生时的中位胎龄为31.617 ± 2.464周(范围25⁺⁶~36⁺³)，SGA组早产儿出生时的身长、体重和矫正胎龄40 w时的身长、体重、头围以及矫正年龄12月时的体重均低于AGA组，差异有统计学意义(P < 0.05)；生长发育迟缓方面，矫正胎龄40周时，SGA组的头围发育迟缓率显著高于AGA组(P < 0.05)；此外，SGA组的智能发育指数(mental development index, MDI)亦低于AGA组(P < 0.05)；虽然SGA组的运动发育指数(psychomotor development index, PDI)同样低于AGA组，但该差异未达到统计学显著水平。结论：足月等效年龄时早产儿SGA的体重增长和智能发育指数仍显著落后于早产AGA，应强化出院后的营养监测及早期精神运动功能训练，以促进早产儿的综合发育。

Abstract: Objective: To analyze and summarize the clinical characteristics, anthropometric status, and neurodevelopmental catch-up trajectories of preterm infants prior to 1 year of age, providing evidence-based guidance for early intervention strategies. Methods: A retrospective analysis was conducted on the hospitalization and follow up data of 60 preterm infants admitted to the Children’s Hospital of Anhui Medical University from December 2023 to December 2024. Descriptive statistical analysis was used. According to birth weight and gestational age, the infants were divided into a preterm small for gestational age (SGA) group (n = 15) and a preterm appropriate for gestational age (AGA) group (n = 45). All infants were followed up to a corrected age of 12 months. The two groups were compared in terms of catch up growth in length and weight, incidence of growth retardation, and psychomotor development indices. Results: Among the 60 preterm infants, 35 (58.33%) were male and 25 (41.67%) were female. The mean gestational age at birth was 31.617 ± 2.464 weeks (range: 25⁺⁶ to 36⁺³ weeks). At birth, the SGA group had significantly lower length and weight than the AGA group. At a corrected gestational age of 40 weeks, the SGA group also showed significantly lower length, weight, and head circumference, and at a corrected age of 12 months, their weight remained significantly lower (P < 0.05). Regarding growth retardation, at a corrected gestational age of 40 weeks, the SGA group had a significantly higher incidence of head circumference retardation compared with the AGA group (P < 0.05). In addition, the Mental Development Index (MDI) was significantly lower in the SGA group than in the AGA group (P < 0.05). Although the Psychomotor Development Index (PDI) was also lower in the SGA group, the difference did not reach statistical significance. Conclusion: At term equivalent age, preterm SGA infants still exhibit significant lags in weight gain and MDI compared with preterm AGA infants. Enhanced post discharge nutritional monitoring and early psychomotor function training should be implemented to promote comprehensive development in these high risk infants.