足月新生儿早期行为神经评分与出生体质量及胎龄的相关性

摘要

Objective To understand behavior neurological development of early full-term newborn,and to analyze the relationships among neonatal behavior neurological assessment,birth weigh and gestational age. Methods By convenience sampling,9 3 cases were selected,and Neonatal Behavior Neurological Assess-ment(20 items)was used to evaluate the behavior neurological ability of 25 small for gestational age infants (SGA),3 5 appropriate for gestational age infants(AGA)and 3 1 large for gestational age infants(LGA)at 48-72 hours after birth.Results Compared with the AGA group,the NBNA total score,behavioral capacity, initiative muscle tonus,general reaction,response to the noise of chuckle,response to the moving red ball, traction reaction,activity in the SGA group and LGA group were significantly lower(P<0.05).They were positively correlated with birth weigh and gestational age in the SGA group,while they were negatively correlated with birth weigh and gestational age in the LGA group.Conclusion The early behavior neuro-logical score is correlated with birth weigh and gestational age.Pregnant women should enhance antenatal care to reduce the incidence of SGA and LGA.We should conduct early intervention to neonates found mild dysfunction of nervous system early,and it is helpful to promote their behavior neurological development.%目的：了解足月新生儿早期行为神经发育水平,探讨行为神经评分与出生体质量及胎龄的相关性.方法2012年5-9月,采用便利抽样法选取莆田学院附属医院妇产科出生的单胎正常足月儿93例,采用新生儿20项行为神经测定(neo-natal behavior neurological assessment,NBNA)法于新生儿出生后48~72 h分别检测25例小于胎龄新生儿(small for gesta-tional age,SGA)、35例适于胎龄新生儿(appropriate for gestational age,AGA)和31例大于胎龄新生儿(large for gestational age,LGA)的行为神经能力.结果与 AGA组相比,SGA 组、LGA 组新生儿的 NBNA 总分、行为能力、主动肌张力、一般反应、对格格声反应、对说话人的反应、红球反应、牵拉反射、活动度评分等均明显降低(P＜0．05)；SGA组新生儿 NBNA各项目评分与出生体质量及胎龄呈正相关,而 LGA组新生儿 NBNA各项目评分则与出生体质量及胎龄呈负相关.结论新生儿早期行为神经评分与出生体质量及胎龄相关；应加强孕妇的孕期保健以减少 SGA及 LGA的发生,对早期发现有行为神经轻微异常的新生儿,应及早进行干预,以促进其行为神经的正常发育.