Clinical Study Of Early Intervention On Nervous System Abnormalities Of High-risk Infants

Objective With the rapid development of perinatal medicine, the survival rate of high-risk infants increased significantly, and mortality rate has decreased dramatically. However, survivals of high-risk infants often accompany with brain injury and neurological sequelae to different degrees. In other words, all perinatal risk factors can lead to severe brain damage and nervous system abnormalities. In this study, we investigated the effect of early intervention on high-risk infants, and evaluated its clinical significance in the prevention and treatment of nervous system abnormalities of high-risk infants. Methods 87 perinatal high-risk infants with complete medical records were selected. The risk factors included preterm (37 cases), hypoxic-ischemic encephalopathy (29 cases) and hyperbilirubinemia (21 cases). Total high-risk infants were divided into early intervention group (n=76) and non-early intervention group (n=11). Infants in early intervention group received intervention program before 1 year old, and infants in non-early intervention group received intervention program after 1 year old. Early intervention group was divided into two subgroups. The infants in group A started intervention program from neonatal period (n=37). The infants in group B started intervention program after neonatal period and till 1 year old (n=39). 12 normal infants were selected as normal controls. High-risk infants accepted different intervention procedures: specific training, rehabilitation, and rehabilitation combined with GM1 drug administration; normal infants accepted conventional guidance. Newboms were evaluated at the first week and the fourth weeks after birth by the method of NBNA. Infants were evaluated monthly by the method of 52 neuromotor test. Results In the first week, the NBNA scores of newborns in group A were significant different compared with those of normal controls (P <0.05 ) except the newborns with hyperbilirubinemia. In the fourth week, scores of high-risk newborns were significant higher than those in the firstweek (P <0. 05), and the scores of high-risk newborns in the fourth week were not significant different compared with the normal newborns (P> 0.05). Evaluation on gross motor development was found that the disparity between early intervention group and normal group decreased gradually as age increasing. In 1 year old, there were no significant difference between early intervention group and normal group (P> 0.05), infants in group A were better than infants in group B. The outcome of 52 neuromotor test showed that 33 high-risk infants (43.42%) in early intervention group had abnormalities before 1 year old, while 5 cases remained anomalies (6.58%) at the age of 1 year old, and one of them was diagnosed as cerebral palsy(1.31%). 7 of 11 infants in non-early intervention group were diagnosed as cerebral palsy(63.63%), and others had serious retardation in motor development. When high-risk infants with nervous system abnormalities accepted intervention treatment, we found that efficacy of rehabilitation combined with GM1 medicine is better than rehabilitation training alone. Conclusions Early intervention on infants with different perinatal risk factors is helpful to improve nervous system development and reduce neurological sequelae due to brain injuries. The improvement would be more significant if the intervention began earlier. Rehabilitation treatment combined with GM1 medicine can improve the efficacy of early intervention.