Study On The Relationship Between Physical Growth And Neuropsychological Development In 99 High-risk Infants

Objective:To collect and analyze the weight,length and neuropsychological development evaluation results of high-risk infants within 6 months in Lanzhou,and to discuss the relationship between them and high-risk factors.Methods:Clinical data of 99 high-risk infants who visiting the child health department of the First Hospital Lanzhou University from December 2016 to September 2017 were collected.The weight and length were measured at the corrected ages of January,March and June,and standard deviation score method was used to assess Z scores of weight,length.The 20 Items Neuromotor Assessments was used to assess the neurological development of each gestational age.Developmental Quotient(DQ)was assessed by Gesell Developmental Scale at corrected of June.Results:1.At corrected age of January,March and June,premature infants with Z scores of weight(t value ranged 6.863-9.525,all P< 0.01 at corrected age of January,March and June),length(t value ranged 7.665-9.500,all P< 0.01 at corrected age of January,March and June)were lower than those term infants,and the differences were statistically significant.2.The premature infants' weight z-score was greater than length z-score at the corrected age of January,March and June.And the premature infants' weight and length increased rapidly from January to March.3.The 20 Items Neuromotor Assessments was used to assess the neurological development in 99 high-risk infants at corrected age of January,February,March and April.The number of failed cases was 88,62,44 and 17.Non-pass rate for the 20 Items Neurological Assessments of high-risk infants was 85.9%(85/99),62.6%(62/99),44.4%(44/99),17.2%(17/99),and the proportion gradually decreased.4.Compared with those with gestational age(GA)(34-36+6)weeks and GA?37 weeks,high-risk infants with GA<34 weeks had significantly reduced DQ scores of gross motor,fine motor,language,adaptive behavior and personal-social behavior(F value was 14.9,19.380,20.946,16.506,19.053,all P< 0.01),and the differences were statistically significant..5.Compared with those with birth weight(BW)(1500-1999)g,(2000-2499)g and 2500 g,high-risk infants with BW of <1500g had also significantly reduced DQ scores of five function areas(F value was 11.658,16.197,20.025,11.480,15.077,all P< 0.01),and the differences were statistically significant.6.At corrected age of June,BW were positively correlated with weight,length and DQ scores on five function areas(P<0.001).In terms of weight,there were a negative correlation with maternal disease(P<0.001).There were a significant negative correlation with neonatal hyperbilirubinemia in terms of gross motor,adaptive behavior(P<0.001).No correlation were found in fine motor,language and personal-social behavior.Canonical correlation analysis were performed between physical development and Gesell DQ values at corrected age of June.There were a linear correlation and the correlation coefficient of 0.471.Conclusion:1.The physical development of high-risk children is relatively backward.The physical development of premature infants lags behind full-term children of the same age.The weight growth of premature infants is superior to the length growth.And the premature infants' weight and length increased rapidly from January to March.2.With the increase of the age of the month,the 20 Items Neuromotor Assessments were examined in high-risk children,and the rate of failure was gradually reduced.3.High-risk infants have different degrees of developmental delay.The younger the gestational age,the lower the birth weight,and the relatively backward neuropsychological development.4.BW is protect factors in high-risk infants physical and neuropsychological development,the female diseases during pregnancy,high neonatal bilirubin concentration is risk factors in high-risk infants physical and neuropsychological development.We should strengthen the prevention and control of disease in the perinatal period and reduce the occurrence of neonatal diseases,drastically improve the prognosis of neuropsychological development in high-risk infants.