晚发型胎儿生长受限婴幼儿生长发育及智力发育评估

摘要

目的 评估晚发型胎儿生长受限(FGR)婴幼儿的生长发育及智力发育状况.方法 收集2011-2013年南京医科大学附属南京妇幼保健院100例晚发型FGR婴幼儿作为研究对象,同期随机抽取100例正常分娩体重婴幼儿纳入对照组.根据FGR胎儿出生体重分为两组,A组(35例)为出生体重低于同孕龄的第5百分位数(包括第5百分位数);B组(65例)为出生体重在同孕龄的第5～10百分位数之间.对婴幼儿出生时及生后3、6、9、12、18个月的体重、身长、头围等数据进行回顾性分析,并通过Gesell发育诊断法进行智力状况评估.结果 100例FGR婴幼儿生长发育有追赶生长现象,其体格发育及智力评估发育商数(DQ)均明显落后于对照组,差异有统计学意义(P＜0.05).A组和B组FGR婴幼儿生长发育指标出生时有明显差异(P＜0.05),随着月龄增长,差异逐渐无统计学意义(P＞ 0.05).结论 FGR儿和正常出生体重儿之间体格发育和智力发育均有差异,FGR儿生长发育有追赶生长现象,应加强对FGR婴幼儿的早期干预及健康监护.%Objective To investigate the physical and intellectual development of infants with late-onset fetal growth restriction (FGR).Methods Totally 100 infants with late-onset FGR admitted to the Nanjing Maternity and Child Health Care Hospital from 2011 and 2013 were selected for study (Group A),and 100 infants with normal birth weight were randomly selected as the control group.The birth weight of infants with FGR in Group A was below the 5th percentile for gestational age while Group B ranged between the 5th percentile and the 10th percentile.The body weight,height and head circumference of infants at birth,and 3,6,9,12 and 18 months after birth were retrospectively analyzed,and the intelligence conditions of the infants were also assessed by Gesell method.Results The physical development and development quotient (DQ) of infants with FGR significantly declined compared to the control group (P＜0.05).The physical development of infants in Group A and Group B differed significantly (P＜0.05),but this difference decreased gradually by the increase of months (P＜0.05).PA catch-up growth was observed in the physical development of FGR group.Conclusion There are significant differences in the physical and intelligence development between the FGR infants and infants with normal birth weight and the catch-up phenomenon is observed in FGR group.The health surveillance with timely interention for infants with FGR should be recommended.