| Objective:Embryonic stage is a critical sensitive period of neurodevelopment in neonates.At the same time,this period also has a strong plasticity and compensatory,the earlier we find the adverse factors and earlier we intervene,the more we can reduce the degree of neonatal neurodevelopmental injury.At present,most studies on the influencing factors of neonatal nervous system development are aimed at the population of premature infants.However,the influencing factors found leading to abnormal nervous system development are mostly related to preterm birth,and it is not certain whether these factors have impact on nervous system development when preterm birth is not caused.In addition,domestic and foreign studies on the influence of neonatal neurodevelopment are mostly focused on a specific type of factors,and there are few studies on the comprehensive effect of various factors,among which the main factors are still unclear.This study the collected information of pregnant women and full-term babies from a People’s Hospital in a city of Jiangxi province nearly a year.Combined with the neural behavior assessment(Neonatal Behavioral Neurological Assessment,NBNA)20 tests,the comprehensive analysis of full-term newborn neural development related influencing factors were researched,maybe can prevent full-term newborn nerve dysplasia and can offer a reference for improving intelligence.Methods:Taking all 2013 mothers and infants born in a People’s Hospital of a city in Jiangxi province from April 2018 to February 2019 as the research objects,the birth weight,length,head circumference,chest circumference and abdominal circumference of all the newborns were measured,and 20 items of NBNA were used to evaluate the development of neonatal nervous system.The general demographic characteristics of parents of newborns,regnant women’s health care,life habits,surroundings and nutrition during pregnancy which may affect the neurological development of newborns were obtained by one-by-one questionnaire survey.At the same time,clinical data such as admission blood pressure,random blood sugar,abdominal circumference,uterine height and blood routine were collected,and Nex ION 300X(Perkin Elmer)inductively coupled plasma mass spectrometer(ICP-MS)was used to determine the contents of zinc(Zn),copper(Cu),lead(Pb)and cadmium(Cd)in venous blood of pregnant women.t-test,one-way ANOVA and correlation analysis were used to analyze the univariate influence of the overall development of neonatal nervous system.The multivariate linear regression was used to study the multivariate influence of the neurological development of full-term neonates.Factor analysis was used to extract the principal components of each factor and then to establish multivariate linear regression with the overall development of neonatal nervous system.Finally,the main influencing factors of neurological development of full-term newborns were obtained.Results:1.Overall situation: The total score of 20 items of NBNA in 2013 newborns was38.55±1.84(27～40),of which 1586 were normal(>37 points),accounting for 78.79%,427 were abnormal(<37 points),accounting for 21.21%.2.Single factor analysis: In the overall single factor analysis of the nervous system,the basic conditions of different newborns(birth season,weight,length,head circumference,abdominal circumference,chest circumference,parity,number of pregnancies),general demographic characteristics of parents(mothers’ nationality,mothers’ age,number of families during pregnancy,residence during pregnancy and two years before pregnancy),dietary status during pregnancy(greasy diet degree,monthly intake of carbohydrates,fruits and meat),basic information of pregnant women [whether amniotic fluid is abnormal,whether neonatal hypoxia,maternal admission blood pressure,uterine height at delivery,white blood cell(WBC)count of pregnant women,blood neutrophil(Neu)count],blood metal content of pregnant women(Zn content,Pb content,Cd content).There were significant differences in the overall development of the nervous system in children(P < 0.05).3.Multivariate analysis:(1)Overall nervous system: neonatal weight,neonatal head circumference and maternal blood Zn content were positively correlated with the overall development of neonatal nervous system;Age,blood pressure,blood Cd,blood lead content and Neu count of pregnant women were negatively correlated with the overall development of neonatal nervous system.(2)Behavioral competence: There was a positive correlation between the newborns’ behavioral competence with the birth season and blood Zn;And a negative correlation between gestational diabetes mellitus(GDM)with neonatal behavioral competence.(3)Passive muscle tension: Neonatal weight,blood Zn content of pregnant women,DHA supplementation during pregnancy and monthly intake of green leafy vegetables were positively correlated with passive muscle tension of neonates;Negative correlations were found between male neonates,age of pregnant women,blood Neu count of pregnant women,blood Cd content,pregnancy vomiting with passive muscle tension of neonates.(4)Active muscle tone: The head circumference of the newborn is positively correlated with the active muscle tone of the newborn;Maternal age,maternal blood Pb and blood Neu count were negatively correlated with neonatal active muscle tone.(5)Primary reflex: Neonatal body weight,number of families during pregnancy,blood Zn,blood Cu,and monthly intake of green leafy vegetables were positively correlated with neonatal primary reflex;The content of blood Cd and Pb was negatively correlated with the original reflex.(6)General assessment: Neonatal weight,head circumference,gestational age,and maternal blood Zn content were positively correlated with the general assessment of neonates;There was a negative correlation between blood Cd content and Neu count in pregnant women with the general assessment of neonates.4.Principal component factor analysis: On the basis of the above analysis,the principal components of the single significant factors affecting the overall development of the nervous system were extracted,and eight main factors were obtained: physical development of the newborn,blood inflammatory cells,pregnancy and childbirth history of pregnant women,residence,dietary and nutritional factors,heavy metals,blood Zn,blood pressure of pregnant women.The above factors were established with the overall development of the nervous system of the newborn.Multivariate linear regression model concluded that: neonatal physical development,blood zinc content of pregnant women and neonatal nervous system development were positively correlated;blood heavy metals and blood inflammatory cells of pregnant women and neonatal nervous development were negatively correlated.Conclusions:1.Emphasis should be laid on the physical development of neonates during pregnancy and the levels of trace elements,especially blood zinc,in the blood of pregnant women,so as to promote the good development of neonatal nervous system;Preventing the increase of blood heavy metal content and blood inflammatory cell content on neonatal nervous system.The adverse effects of pregnancy age and blood pressure on the overall development of the neonatal nervous system cannot be ignored.2.Newborn gestational age,maternal blood Cu content,green leafy vegetable intake,the number of families during pregnancy,DHA intake during pregnancy,birth quarter have positive development of one or some dimensions of the neonatal nervous system;There is a negative correlation pregnant women with GDM,morning sickness during pregnancy.Although the above factors only affect the development of individual dimensions of neonatal nerves,additional attention should be paid to the overall development of the nervous system. |
PDF Full Text Request