The Retrospective Study Of206Preterm Infants’Assessment By Gesell Developmental Scale

Objective:When the survival rate of premature infant has increased in recent years, the long-term outcome of those preterm infants attracts more and more attentions. We investigate the results of Gesell Developmental Scale for the preterm infants to discover the high risk factor about the long term bad neurological outcome, and how to give them the effective intervention and improve their neurological outcome.Method:We designed the preterm infants individual questionnaire to collect clinical date of preterm infants and their mother from Maternal and Child Health Care Centre of Changsha City, and then tested their Developmental quotient (DQ) between their correct age (CA) of2months (ms) to24ms by the Gesell Developmental Scale.Result:206of the preterm infants were enrolled in this study from January2008to October2012. The median of the birth weight (BW) in these preterm infants is2100g (840g-3600g). The median of the gestational age (GA) in these preterm infants is34.5-weeks (wks)(25+6-36+6wks). The preterm infants were divided into three subgroups, including CA2-5.9ms (73cases),6-11.9ms (108cases),12-24ms (25cases). In the preterm infants with CA2-5.9ms or6-11.9ms, the DQs of the adaptability, gross motor movement, fine movement and social contact in the preterm infants with BW<1500g decreased significantly than those in the infants with BW≥2500g,2000-2499g or1500-1999g (P<0.05); the DQs of language in the preterm infants with BW<1500g decreased significantly than that in the infants with BW≥2500g or2000-2499g (P<0.05). In the preterm infants with CA6-11.9ms, the DQs of the gross motor movement and social contact in the preterm infants with BW<1500g decreased significantly than those in the infants with BW>2500g or2000-2499g (P<0.05).. In the preterm infants with CA12-24ms, the DQs of gross motor in the preterm infants with BW<1500g decreased significantly than that in the infant with BW>2500g (P<0.05).In the preterm infants with CA2-5.9ms or6-11.9ms, the DQs of the adaptability, gross motor movement, fine movement and social contact in the preterm infants with GA<32weeks decreased significantly than those in the infants with GA35-36+6wks or32-34+6wks (P<0.05). In the preterm infants with CA2-5.9ms, the DQs of the gross motor movement and social contact in the preterm infants with GA32-34+6wks decreased significantly than those in the infants with GA35-36+6wks (P<0.05). In the preterm infants with CA12-24ms, the DQs of the adaptability, gross motor movement and social contact in the preterm infants with GA<35wks decreased significantly than those in the infants with GA35-36+6wks (P<0.05)..In the preterm infants with CA2-5.9ms, the DQs of adaptability, gross movement, fine movement, language and social contact were strongly related to GA and BW(P<0.05);the DQs of adaptability was strongly related to eclampsia, neonatal respiratory distress syndrome (NRDS), patent ductus arteriosus (PDA), anemia, hypoglycemia and blood transfusion (P<0.05); the DQs of fine movement was strongly related to prenatal application of corticosteroids, NRDS, anemia, infectious disease, hypoglycemia, and mechanical ventilation (P<0.05); the DQs of language was strongly related to anemia, infectious disease and blood transfusion (P<0.05); the DQs of social contact was strongly related to NRDS, PDA, hemorrhage of digestive tract, anemia, infectious disease, hypoglycemia, mechanical ventilation and blood transfusion (P<0.05). In the preterm infants with CA6-11.9ms, the DQs of adaptability, gross movement, fine movement, language and social contact were strongly related to GA and BW, too (P<0.001); the DQs of adaptability was strongly related to eclampsia, NRDS, neonatal pneumonia, mechanical ventilation, anemia and blood transfusion and hypoglycemia (P<0.05); the DQs of gross movement was strongly related to eclampsia, NRDS, PDA, neonatal pneumonia, anemia and blood transfusion, mechanical ventilation, hemorrhage of digestive tract, infectious disease and hypoglycemia(P<0.05); the DQs of fine movement was strongly related to eclampsia, NRDS, anemia, infectious disease, hypoglycemia, mechanical ventilation and blood transfusion (P<0.05); the DQs of language and social contact were strongly related to eclampsia, NRDS, neonatal pneumonia, anemia, hypoglycemia, mechanical ventilation and blood transfusion (P<0.05). In the preterm infants with CA12-24ms, the DQs of adaptability, gross movement, fine movement, language and social contact were strongly related to eclampsia (P<0.05); the DQs of gross movement was strongly related to GA and BW (P<0.05); the DQs of fine movement was strongly related to neonatal pneumonia, periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH)(P<0.05); the DQs of social contact and gross movement was strongly related to hypoglycemia(P<0.05).Conclusions:1. the preterm infants with BW less than1500g or GA less than32wks is the high risk group with the normality of the adaptability, gross motor movement, fine movement and social contact. These preterm infants must be followed up carefully.2. The severe complications in neonatal period may be association with long-term neurological abnormal outcome, so the preterm infants with these complications should be paid attention to nervous system development.