Impact of early term and late preterm birth on infants' neurodevelopment: evidence from a cohort study in Wuhan, China.
Impact of early term and late preterm birth on infants' neurodevelopment: evidence from a cohort study in Wuhan, China.
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早期足月和晚期早产对婴儿神经发育的影响：来自中国武汉的一项队列研究的证据
DOI：
10.1186/s12887-022-03312-3
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发表时间：
2022-05-05
期刊：
影响因子：
2.4
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中科院分区：
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近年来，早产和晚期早产的发病率在全球范围内不断上升。然而，关于早产和晚期早产对婴儿神经发育的影响，尤其是早期神经发育的影响，目前还缺乏前瞻性研究。因此，我们开展了这项队列研究，以调查早产和晚期早产对婴儿 6 个月内神经发育的影响。
这项队列研究于 2012 年 10 月至 2013 年 9 月在中国武汉进行。研究共纳入了4243名在武汉市儿童医院妊娠34-41周内出生的单胎婴儿。采用格塞尔发育量表（GDS）评估婴儿的神经发育情况。
在4243名参与者中，155名（3.65%）为晚期早产儿，1288名（30.36%）为早期足月儿，2800名（65.99%）为足月儿。在对潜在的混杂因素进行调整后，晚期早产与神经发育各领域的发育商数（DQ）之间存在显著的负相关：粗大运动（β = - 17.42，95% CI：- 21.15 至 - 13.69）、精细运动（β = - 23.61，95% CI：- 28.52 至 - 18.69）、适应能力（β = - 10.10，95% CI：- 13.82 至 - 6.38）、语言（β = - 6.28，95% CI：- 9.82 至 - 2.74）和社会行为（β = - 5.99，95% CI：- 9.59 至 - 2.39）。早产儿的精细动作 DQ 呈明显的负趋势（β = - 2.01，95% CI：- 3.93 至 - 0.09）。晚期早产儿在粗大运动（调整 OR = 3.82，95% CI：2.67 至 5.46）、精细运动（调整 OR = 3.51，95% CI：2.47 至 5.01）和适应能力（调整 OR = 1.60，95% CI：1.12 至 2.29）方面出现神经发育迟缓的风险明显升高，而早产儿与精细运动神经发育迟缓明显相关（调整 OR = 1.22，95% CI：1.05 至 1.42）。
这项研究表明，晚期早产主要会增加大运动、精细运动和适应能力神经发育迟缓的风险，而早产则与6个月内精细运动的发育迟缓有关。对于早产儿和晚期早产儿疑似神经发育迟缓的情况，需要进一步研究确定早期干预的有效性和必要性。
The incidences of early term and late preterm birth have increased worldwide during recent years. However, there is a lack of prospective study about the influence of early term and late preterm birth on infants’ neurodevelopment, especially at the early stage. Therefore, we conducted this cohort study to investigate the impact of early term and late preterm birth on infants’ neurodevelopment within 6 months. This cohort study was conducted in Wuhan, China, between October 2012 and September 2013. A total of 4243 singleton infants born within 34-41 weeks of gestation at Wuhan Children’s Hospital were included. The Gesell Developmental Scale (GDS) was utilized to evaluate the neurodevelopment of infants. Among the 4243 included participants, 155 (3.65%) were late preterm infants, 1288 (30.36%) were early term infants, and 2800 (65.99%) were full term infants. After adjusted for potential confounders, significant negative relationship was shown between late preterm birth and development quotient (DQ) in all domains of neurodevelopment: gross motor (β = − 17.42, 95% CI: − 21.15 to − 13.69), fine motor (β = − 23.61, 95% CI: − 28.52 to − 18.69), adaptability (β = − 10.10, 95% CI: − 13.82 to − 6.38), language (β = − 6.28, 95% CI: − 9.82 to − 2.74) and social behavior (β = − 5.99, 95% CI: − 9.59 to − 2.39). There was a significant negative trend for early term birth in DQ of fine motor (β = − 2.01, 95% CI: − 3.93 to − 0.09). Late preterm infants had a significantly elevated risk of neurodevelopmental delay in domains of gross motor (adjusted OR = 3.82, 95% CI: 2.67 to 5.46), fine motor (adjusted OR = 3.51, 95% CI: 2.47 to 5.01), and adaptability (adjusted OR = 1.60, 95% CI: 1.12 to 2.29), whereas early term birth was significantly associated with neurodevelopmental delay of fine motor (adjusted OR = 1.22, 95% CI: 1.05 to 1.42). This study suggested that late preterm birth mainly elevated the risk of neurodevelopmental delay of gross motor, fine motor, and adaptability, whereas early term birth was associated with the developmental delay of fine motor within 6 months. Further research is needed to determine the effectiveness and necessity of the interventions at the early stage for early term and late preterm infants who had suspected neurodevelopmental delay.