Factors Affecting The Mental And Physical Development Of Early Preterm Infants

Objective: To evaluate the catch-up growth and mental development of early preterm infants with gestational age less than 34 weeks and to analyze the influencing factors.Methods: The medical history of early preterm infants with gestational age less than 34 weeks and full-term infants were retrospectively collected.The body development was evaluated by height,weight and head circumference.And the physical growth and mental development of the participants less than three years old were observed.The Gesell Developmental Schedules were used for mental development assessment.Meanwhile,a questionnaire survey was conducted in the trial.Thus,the factors affecting the physical and developmental status of early preterm infants could be analyzed.Results:1.Factors influencing the level of Gesell test results in early preterm infantsIn the control of gestational age factors,the early preterm infants of different birth weight groups were not statistically significant at the age of 12 months,24 months,and 36 months about gross motor,fine motor,adaptability,language and personal-social abilities’ developmental quotient(DQ)levels.(p>0.05).There was no statistically significant difference in the DQ level of premature infants with or without early education classes or with or without the use of assisted reproductive technology by their mothers and with different parents ’ education,occupation,average daily companion time,and annual family income(p > 0.05).However,the grade of DQ had statistical difference with the comfort level of family life(p<0.05).Speech abilities had statistical difference with gender(p<0.05).The language and personal-social abilities of male infants were behind female infants at least one level(OR=6.83 and OR=9.497 respectively).The gross motor had statistical difference with whether the preterm infant was the one-child(p<0.05).Compared with infants having siblings,the one-child infants were at least one level behind in terms of gross motor ability(OR = 0.185).Fine motor and adaptability had statistical difference with the health status of the mothers during pregnancy(p<0.05).If mother’s health status during pregnancy is very good,good or average compared with poor,the DQ of fine motor was higher at least one level(OR=9.879,OR=1.414,OR=1.436 respectively),the DQ of adaptability was higher at least one level(OR=4.911,OR= 5.355,OR= 2.267).2.Follow-up of physical development after birthThe length and weight of preterm infants with gestational age less than 30 weeks were overtaken in the full-term infant group with gestational age ranging from 30 to 36 months.The remaining preterm infant group did not catch up with the full-term infants before the age of 36 months regarding length,weight and head circumference.The length,weight and head circumference of preterm infants with birth weight less than 1250 g did not catch up with normal full-term children before the age of 36 months.The length of the group with birth weight between 1250 g and 1500 g was able to catch up with the full-term group at 30-36 months.The length and weight of the group with birth weight between 1500 g and 2000 g were able to catch up with the full-term child group at 24-30 months.The weight of the group with birth weight between 2000 g and 2500 g caught on the full-term infant group at 24-30 months.3.Gesell development testThe DQ of preterm infants in different gestational age groups at the age of 12,24,and 36 months was lower than that of the full-term infants,showing statistically significant difference(p<0.05).The percentage of the children identified as “normal DQ” increases with age except the adaptability.Conclusions:1.In the case of controlling the gestational age factor,female preterm infants can have higher levels of speech ability than males.Premature infants with comfortable living conditions have higher levels of adaptability and personal-social abilities.Premature babies with siblings have higher levels of motor ability.The premature infants whose mothers are healthy during pregnancy have higher levels of fine motor function,verbal ability,and personal-social ability.2.The premature infants with gestational age less than 30 weeks caught up with the full-term infants in length and weight at 30-36 months.The remaining premature infant groups did not catch up with full-term infants before 36 months,but the general trend was catch-up growth.3.Premature infants with different birth weights lag behind full-term children in physical development before 24 months.Premature infants with birth weight more than 1250 g caught up with full-term infants during 24-36 months gradually.Premature infants with birth weight less than 1250 g failed to catch up with full-term infants before 36 months.4.All aspects of the mental and physical development of early premature infants are behind that of the full-term infants.The older the gestational age the premature infants have,the closer the development of gross motor ability,speech ability and personal-social ability of premature infants is to that of full-term infants.5.Premature infants,especially those with smaller gestational age and lower birth weight,have significant differences regarding physical growth and mental development compared with full-term infants.Thus,long-term childcare and interventions should be followed up as early as possible to avoid adverse effects on the life,study,and social aspects of preterm infants.