Journal of Shanghai Jiao Tong University (Medical Science) ›› 2023, Vol. 43 ›› Issue (4): 445-452.doi: 10.3969/j.issn.1674-8115.2023.04.006

• Clinical research • Previous Articles    

Current status of neurodevelopmental outcomes and its influencing factors of early-to-moderate preterm infants at corrected age of 18 months

SHEN Li1,2(), HUANG Hengye1(), YU Guangjun3()   

  1. 1.Shanghai Jiao Tong University School of Public Health, Shanghai 200025, China
    2.Clinical Research Center, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
    3.Children's Precision Medicine Engineering Technology Research Center, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200040, China
  • Received:2022-11-12 Accepted:2023-03-14 Online:2023-04-28 Published:2023-04-28
  • Contact: HUANG Hengye,YU Guangjun E-mail:shenli_0510@126.com;hengyehuang@sjtu.edu.cn;gjyu@shchildren.com.cn
  • Supported by:
    Clinical Research Plan of Shanghai Hospital Development Center for Multi-Center Clinical Research of Major Diseases(SHDC2020CR1047B)

Abstract:

Objective ·To analyze the neurodevelopmental outcomes and risk factors of early-to-moderate preterm infants with gestational age≤34 weeks at corrected age of 18 months. Methods ·The early-to-moderate preterm infants hospitalized in Neonatal Intensive Care Unit of Shanghai Children's Hospital from January 2013 to April 2020, and regularly followed up after discharge were included in this study. Demographic and clinically relevant data of preterm infants and their parents were collected. The infants were divided into the neurodevelopmental retardation group and the normal neurodevelopment group according to their Gesell Development Schedule (GDS) scores at corrected age of 18 months. The demographic characteristics of preterm infants, birth status, demographic characteristics of parents and prenatal examinations between the two groups were compared, and stepwise Logistic regression was used to explore the factors influencing neurodevelopmental outcomes in preterm infants. Results ·A total of 929 preterm infants were included in the study, including 527 boys (56.7%) and 402 girls (43.3%), with a mean gestational age of (31.06±2.23) weeks and 138 (14.9%) extremely preterm infants. A total of 147 infants (15.8%) had neurodevelopmental retardation of early-to-moderate preterm infants at corrected age of 18 months, with abnormalities of 7.4%, 9.7%, 17.9%, 14.2% and 13.7% in gross motor, fine motor, language, adaptive behavior and personal-social behavior, respectively. A comparison of the clinical characteristics between the neurodevelopmental retardation group and the normal neurodevelopment group revealed statistically significant differences in terms of gender, whether the baby was an extremely preterm infant, birth weight, mode of delivery, and occurrence of intrauterine distress (all P<0.05). Stepwise Logistic regression analysis showed that boys (OR=1.60, 95%CI 1.05?2.44, P=0.028), cesarean section (OR=1.67, 95%CI 1.08?2.60, P=0.022), extremely preterm infants (OR=2.20, 95%CI 1.34?3.62, P=0.002) and intrauterine distress (OR=5.03, 95%CI 2.11?11.99, P=0.000) were the risk factors for neurodevelopmental retardation. Conclusion ·Boys, extremely preterm infants, cesarean section and intrauterine distress may increase the neurodevelopmental retardation risk of early-to-moderate preterm infants and improving follow-up management of these preterm infants should be focused on and enhanced.

Key words: preterm infant, neurodevelopment, neurodevelopmental retardation, risk factor, Gesell Development Schedule

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