Influencing factors analysis of neurobehavioral development in extremely low birth weight infants

Abstract

Objective To investigate influencing factors of neurobehavioral development in extremely low birth weight infants (ELBWI). Methods From January 1, 2010 to May 31, 2015, a total of 88 ELBWI in the neonatal intensive care unit (NICU) of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, were included into this study. They were divided into neurobehavioral development disability group (n=15) and neurobehavioral development normal group (n=73) according to the follow-up results with neurobehavioral development or not. The clinical data between two groups were analyzed, and influencing factors of neurobehavioral development in ELBWI were analyzed by statistical analysis. ① A total of 8 items of maternal information between two groups were compared, including proportion of maternal age >35-year-old and non-exposure to prenatal hormones, assisted reproductive technology, gestational hypertension disease, gestational diabetes mellitus, premature rupture of membranes, and intrauterine infection, and intrahepatic cholestasis of pregnancy (ICP). ② A total of 18 items of ELBWI between two groups were compared, including constituent ratio of gestational age, and proportion of small for age (SGA) infants, intraventricular hemorrhage (IVH) grade III-IV, and so on. Based on the existing studies, clinical experience and univariate analysis results, the 4 influencing factors related to neurodevelopmental outcomes of ELBWI were analyzed by multivariate unconditional logistic analysis. The procedures followed in this study were in line with the ethical standards set by Ethical Review Board of Investigation in Human Beings of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region and were approved by the committee. Results ①The univariate analysis showed the following results. The proportion of intrauterine infection of puerperant in neurobehavioral development disability group was higher than that of neurobehavioral development normal group, the constituent ratio of gestational age of ELBWI in neurobehavioral development disability group was younger than that of neurobehavioral development normal group, furthermore, the proportions of SGA infants and IVH grade Ⅲ-Ⅳ in neurobehavioral development disability group were higher than those in neurobehavioral development normal group, and all the above differences were statistically significant (P<0.05). ② Multivariate unconditional logistic analysis showed the following results. Intrauterine infection (OR=43.644, 95%CI: 2.545-748.368, P=0.009) and IVH grade Ⅲ-Ⅳ (OR=55.837, 95%CI: 3.422-910.988, P=0.005) were independent risk factors about neurobehavioral development in ELBWI. Gestational age (OR=0.067, 95%CI: 0.006-0.821, P=0.035) was the independent protective factor about neurobehavioral development in ELBWI. Conclusions It is necessary to take active measures to prevent neurodevelopmental disability by preventing premature delivery, controlling intrauterine infection and reducing the occurrence of severe IVH. Key words: Developmental disabilities; Risk factors; Prognosis; Infant, extremely low birth weight