Objective: To study the effect of bronchopulmonary dysplasia (BPD) on neurobehavioral development within one year after birth in preterm infants.
Methods: A retrospective analysis was performed for the preterm infants with a gestational age of <34 weeks who were born from September 2017 to December 2019 and completed the follow-up assessments of neurobehavioral development at the corrected gestational ages of 40 weeks and 3, 6, and 12 months. According to their diagnosis, they were divided into a BPD group with 23 infants and a non-BPD group with 27 infants. The outcome of neurobehavioral development was compared between the two groups at different time points.
Results: There was no significant difference in the neonatal behavioral neurological assessment score between the BPD and non-BPD groups at the corrected gestational age of 40 weeks (P>0.05). Based on the Gesell Developmental Scale, compared with the non-BPD group, the BPD group had significantly lower global developmental quotient (DQ) and DQs of fine motor, adaptive behavior, and personal-social behavior at the corrected gestational ages of 3, 6, and 12 months (P<0.05). For both groups, the DQ of language at the corrected gestational age of 6 months was significantly higher than that at the corrected gestational age of 12 months (P<0.017), the DQ of personal-social behavior at the corrected gestational age of 6 months was significantly higher than that at the corrected gestational age of 3 months (P<0.017), and the DQ of adaptive behavior at the corrected gestational age of 12 months was significantly higher than that at the corrected gestational ages of 3 and 6 months (P<0.017). Based on the BSID-II scale, there were no significant differences in mental development index and psychomotor development index at each time point between the two groups (P>0.05). The mental development index at the corrected gestational age of 3 months was significantly higher than that at the corrected gestational ages of 6 and 12 months in both groups (P<0.001).
Conclusions: Preterm infants with BPD have delayed neurodevelopment within one year after birth compared with those without BPD, which should be taken seriously in clinical practice.
目的: 探讨支气管肺发育不良(BPD)对早产儿生后1年内神经行为发育的影响。
方法: 回顾性选取2017年9月至2019年12月间出生胎龄 < 34周,并完成纠正胎龄40周及3、6、12月龄神经行为发育随访的早产儿为研究对象。根据诊断分为BPD组(n=23)和非BPD组(n=27),比较两组患儿不同时点的神经行为发育结果。
结果: BPD组与非BPD组患儿纠正胎龄40周时新生儿神经行为测定评分差异无统计学意义(P > 0.05)。Gesell发育量表中,BPD组纠正胎龄3、6、12月龄时精细动作、适应性行为、社交行为能区发育商(DQ)及总DQ低于非BPD组(P < 0.05);两组患儿纠正胎龄6月龄时言语能区DQ高于纠正胎龄12月龄(P < 0.017),纠正胎龄6月龄时社交行为能区DQ高于纠正胎龄3月龄(P < 0.017),纠正胎龄12月龄时适应性行为能区DQ高于纠正胎龄3、6月龄(P < 0.017)。Bayley发育量表Ⅱ中,两组患儿各时点智力和运动发展指数差异无统计学意义(P > 0.05),纠正胎龄3月龄时智力发展指数高于纠正胎龄6、12月龄(P < 0.001)。
结论: BPD早产儿在生后1年内较非BPD早产儿存在神经发育落后,临床需给予重视。