早产小于胎龄儿生后2岁内体格及运动发育状况的随访研究

doi:10.19723/j.issn.1671-167X.2025.06.016

Abstract

Abstract:

Objective: To investigate the physical and motor development of preterm small for gestational age infant (SGA) within 2 years after birth. Methods: SGA born in Peking University Third Hospital from January 1, 2018 to December 31, 2022 and followed up regularly in the Center for Child Health and Deve-lopment were selected as study subjects. They were divided into preterm SGA group and full-term SGA group. Length, weight, head circumference, Peabody motor development score, vitamin A and D, bone mineral density and feeding status of SGA 0-3, 3-6, 6-10, 10-16, 16-21, 21-27 months after birth were collected through the electronic child health care follow-up system. The preterm infants were calculated according to the corrected gestational age. SPSS 25.0 statistical software was used to analyze the data. Results: A total of 158 SGA completed the regular follow-up, including 87 preterm SGA and 71 full-term SGA. The birth length, weight and head circumference of the two groups were statistically significant (all P < 0.05). The body weight of preterm SGA caught up faster 0-3 months after birth, and the head circumference of preterm SGA was higher than that of full-term SGA 0-3 months [(38.18±2.14) cm vs. (37.12±1.66) cm] and 6-10 months [(43.04±1.54) cm vs. (42.35±1.70) cm] after birth. The differences were statistically significant (all P < 0.05). The scores of gross motor, fine motor and total motor development 3-6 and 6-10 months after birth were significantly higher in preterm SGA than in full-term SGA (all P < 0.05). Breastfeeding 0-3 months of age and 3-6 months of age was significantly associated with catch-up growth in preterm SGA (P < 0.05). There were no significant differences in vitamins A and D and bone mineral density between the two groups. Conclusion: In the first year after birth, the weight and head circumference of preterm SGA increase faster than those of full-term SGA, and the motor development of preterm SGA is better than that of full-term SGA. After the first year of life, the physical indicators and motor development of the two groups tend to be consistent. Breastfeeding is the preferred feeding mode for preterm SGA, which promotes rapid catch-up growth in the early stage. The absence of maternal diabetes during pregnancy is also one of the positive factors for the occurrence of catch-up growth in SGA.

Key words: Small for gestational age infant, Physical development, Motor development, Weight gain, Breastfeeding

CLC Number:

R722

Ping ZHENG, Kunhong LIN, Mengyuan LIU, Xuyan ZHAO, Yangxin XIAO, Yan XING. A follow-up study on the physical and motor development of premature infants with small for gestational age within 2 years after birth[J].Journal of Peking University (Health Sciences), 2025, 57(6): 1124-1131.

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References 28

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Months of age	Group	Weight/kg		Body length/cm		Head circumference/cm
Months of age	Group	n	$\bar x \pm s$	n	$\bar x \pm s$	n	$\bar x \pm s$
At the moment of birth	Full-term	71	2.28±0.30	71	45.70±2.31	41	32.26±1.56
	Preterm	87	1.47±0.41^*	87	39.37±4.39^*	55	28.72±2.77^*
0-3	Full-term	39	4.30±0.86	39	54.49±3.18	38	37.12±1.66
	Preterm	81	4.81±1.15^*	81	55.54±4.27	81	38.18±2.14^*
3-6	Full-term	64	6.39±0.98	64	62.54±3.01	63	40.58±1.60
	Preterm	73	6.48±0.97	73	62.34±3.12	73	41.00±1.61
6-10	Full-term	58	7.45±1.06	58	66.65±2.86	57	42.35±1.70
	Preterm	76	7.53±1.07	76	67.37±2.68	74	43.04±1.54^*
10-16	Full-term	53	8.79±1.15	52	72.82±3.23	52	44.76±1.42
	Preterm	59	8.82±1.18	59	73.84±2.87	58	44.83±1.59
16-21	Full-term	26	9.78±1.27	26	78.76±3.64	24	45.78±1.36
	Preterm	44	9.64±1.10	44	78.93±3.44	44	45.65±2.58
21-27	Full-term	13	11.23±1.86	13	85.63±6.23	12	47.39±0.99
	Preterm	32	10.89±1.26	31	85.87±4.31	31	46.68±1.67

Months of age	Groups	Catch-up group，n(%)	No catch-up group, n(%)	Statistics	P
0-3	Full-term	20 (51.3)	19 (48.7)	χ²=3.610	0.057
0-3	Preterm	56 (69.1)	25 (30.9)
3-6	Full-term	46 (71.9)	18 (28.1)	χ²=0.067	0.796
3-6	Preterm	51 (69.9)	22 (30.1)
6-10	Full-term	45 (77.6)	13 (22.4)	χ²=1.032	0.310
6-10	Preterm	53 (69.7)	23 (30.3)
10-16	Full-term	45 (84.9)	8 (15.1)	χ²=3.031	0.082
10-16	Preterm	42 (71.2)	17 (28.8)
16-21	Full-term	19 (73.1)	7 (26.9)	χ²=0.388	0.533
16-21	Preterm	35 (79.5)	9 (20.5)
21-27	Full-term	11 (84.6)	2 (15.4)		0.696^a
21-27	Preterm	23 (71.9)	9 (28.1)

Months of age	Groups	n	Bone mineral density (Z value)，$\bar x \pm s$	t	P
0-3	Full-term	31	-1.510±0.995	2.123	0.928
0-3	Preterm	68	-1.980±1.050
3-6	Full-term	59	-1.306±1.220	0.760	0.699
3-6	Preterm	65	-1.465±1.098
6-10	Full-term	51	-0.792±0.918	0.495	0.532
6-10	Preterm	57	-0.875±0.830
10-16	Full-term	47	0.034±0.936	-0.927	0.832
10-16	Preterm	50	0.210±0.932
16-21	Full-term	21	0.367±1.075	-0.236	0.843
16-21	Preterm	29	0.438±1.037
21-27	Full-term	11	0.552±1.088	0.269	0.961
21-27	Preterm	26	0.438±1.214

Months of age	Groups	n	GMQ, $\bar x \pm s$	FMQ, $\bar x \pm s$	TDQ, $\bar x \pm s$
0-3	Full-term	10	99.50±5.68	102.00±8.08	101.60±6.62
	Preterm	57	101.26±5.64	100.60±6.04	100.89±5.57
3-6	Full-term	26	96.00±5.00	97.58±4.57	96.65±3.57
	Preterm	62	99.79±4.83^*	101.35±4.63^*	100.31±4.69^*
6-10	Full-term	24	96.88±4.91	97.38±4.83	96.60±3.53
	Preterm	45	100.16±5.90^*	100.60±5.30^*	100.16±5.13^*
10-16	Full-term	18	97.06±7.47	100.22±8.18	97.84±7.94
	Preterm	33	96.09±6.62	102.00±8.51	98.24±7.11
16-21	Full-term	9	100.22±9.44	99.67±9.90	100.47±7.92
	Preterm	21	97.71±7.89	104.00±4.87	100.33±5.96
21-27	Full-term	5	99.60±4.78	97.80±12.78	100.00±4.79
	Preterm	7	97.86±5.05	100.43±2.70	98.71±2.29

Months of age	Feeding patterns	Catch-up, n(%)	No catch-up, n(%)	P	aOR	95%CI
0-3	Breast milk	19 (86.4)	3 (13.6)	0.045	6.29	1.04-37.8
	Formula milk	7 (53.8)	6 (46.2)	0.965	1.04	0.18-6.03
	Mixed	20 (80.0)	5 (20.0)	0.149	3.19	0.66-15.43
3-6	Breast milk	15 (83.3)	3 (16.7)	0.024	27.67	1.54-499.04
	Formula milk	13 (61.9)	8 (38.1)	0.372	3.62	0.22-61.11
	Mixed	22 (78.6)	6 (21.4)	0.074	12.89	0.78-212.40

A follow-up study on the physical and motor development of premature infants with small for gestational age within 2 years after birth

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Factors	CUG1		CUG2		CUG3		CUG4		CUG5		CUG6
Factors	Yes	No	Yes	No	Yes	No	Yes	No	Yes	No	Yes	No
Gestational hypertension
No	32	21	50	20	48	19	42	9	20	7	12	4
Yes	44	23	47	20	50	17	45	16	33	10	20	6
P	0.550		0.869		0.697		0.277		0.800		>0.999
Gestational diabetes mellitus
No	51	27	72	22	68	21	61	12	36	9	24	5
Yes	25	17	25	18	30	15	26	13	17	8	8	5
P	0.525		0.027		0.230		0.041		0.262		0.238
Liver and kidney diseases
No	73	39	91	35	92	33	82	22	49	16	32	9
Yes	3	5	6	5	6	3	5	3	4	1	0	1
P	0.141		0.298		0.701		0.374		>0.999		0.238
Placental abnormalities
No	67	36	83	32	85	32	76	22	51	14	32	10
Yes	9	8	14	8	13	4	11	3	2	3	0	0
P	0.337		0.420		0.783		>0.999		0.088
Umbilical cord abnormalities
No	67	37	85	34	86	34	76	24	48	17	29	10
Yes	9	7	12	6	12	2	11	1	5	0	3	0
P	0.528		0.679		0.351		0.294		0.325		0.568
Twin pregnancy
No	53	36	74	34	80	29	70	21	42	14	28	9
Yes	23	8	23	6	18	7	17	4	11	3	4	1
P	0.145		0.256		0.887		0.780		>0.999		>0.999

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