新生儿重症监护室早产儿的神经发育结果

Mosammad Alpana Jahan, Afroza Islam Shuma, Rabeya Sultana, Rumman, I. Jahan, M. Shabuj, S. Dey, M A Mannan, M. Shahidullah
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引用次数: 0

摘要

导言:随着早产儿存活率的提高,如何处理长期并发症,尤其是神经发育障碍,已成为改善早产儿生活的一个重要问题。目的:评估新生儿重症监护室(NICU)收治的早产儿神经发育不良后果的相关因素。方法和材料:这项前瞻性队列研究在孟加拉国达卡 BSMMU 新生儿科进行。从新生儿重症监护室出院的早产儿(小于 34 周)被纳入研究,并在 6 个月大时接受神经发育评估。记录了婴儿的产前、围产期和产后特征。贝利-III量表用于评估综合评分。连续变量采用独立 t 检验,分类变量采用卡方检验。为找出风险因素与神经发育评分的关系,进行了逻辑回归分析。结果共有 47 名患者在 6 个月大时使用 Bayley 量表 III 进行了分析。平均出生体重和胎龄分别为 1595.11±377.17 克和 32.43±1.48 周。认知、运动和语言的平均得分分别为 80.79±14.51、82.87±14.53 和 82.98±13.72。尽管所有平均得分都正常,但仍有 27.7% 的婴儿认知、23.4% 的婴儿运动和 31.9% 的婴儿语言的 BSID-III 值小于 70。胎龄小于 30 周、出生体重小于 1500 克和惊厥等变量都与神经发育不良有关。然而,回归分析表明,这些变量均不显著。结论在我们的研究中,早产新生儿(妊娠不足 34 周)六个月大时的认知、语言和运动评分均在正常范围内。我们观察到,27.7%的新生儿有认知发育迟缓,31.9%的新生儿有语言发育迟缓。J Dhaka Med Coll.2022; 31(2) : 251-257
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Neurodevelopment Outcome among Preterm Infants Admitted in Neonatal Intensive Care Unit
Introduction: With increasing the survival rates of premature babies, the management of long term complications, especially neurodevelopmental disorder is becoming an important issue for a better life. Aims: To assess the factors associated with adverse neurodevelopment outcome among preterm infants admitted in Neonatal Intensive Care Unit (NICU). Methods and Material: This prospective cohort study was conducted in Department of Neonatology, BSMMU, Dhaka, Bangladesh. Premature infants (<34 weeks) discharged from the NICU were enrolled and followed up for neurodevelopmental assessment at 6 months of age. Prenatal, perinatal, and postnatal features of the babies were recorded. The Bayley-III scale was used to assess the composite scores. Continuous variables were analyzed using an independent t-test and categorical variables with chi-square test. Logistic regression analysis was performed to find out the relationship of risk factors with neurodevelopmental scores. Results: A total 47 patients were analysed at 6 months of age using Bayley scale III. Mean birth weight and gestational age was 1595.11 ± 377.17g and 32.43 ± 1.48 weeks respectively. Mean cognitive, motor and language score were 80.79±14.51, 82.87±14.53 and 82.98±13.72 respectively. Despite the fact that all mean scores were normal, 27.7% of infants in cognition, 23.4% in motor, and 31.9% in language had a BSID-III value < 70. Variables like gestational age < 30 weeks, birth weight <1500 grams, and convulsion have been linked to poor neurodevelopmental outcomes. However, regression analysis revealed none of them were significant. Conclusions: In our study, at six months of age, the cognitive, language, and motor scores of preterm newborns (less than 34 weeks of gestation) were within normal limits. Of the newborns, we observed that 27.7% had cognitive delay and 31.9% experienced language delay. J Dhaka Med Coll. 2022; 31(2) : 251-257
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