Research Of Clinical Characteristics And Neuropsychological Development In Twin Premature Infants

Objective:To explore the clinical characteristics and neuropsychological development in twin premature infants, and to analyze the risk factors leading to the retardation of develop-ment, as well as to provide some guidance for clinical work in future.Methods:1. The clinical data of593premature infants hospitalized in our neonatal ward were collected from June2010to June2012, including gestational age, birth weight and neonatal complications. The premature infants were divided into two groups:study group of131twin premature infants and control group of462singleton premature infants. The clinical data of the two groups were statistically analyzed.2. The neuropsychological development of88premature infants were evaluated at corrected gestational age of1years old by Bayley scales of infant development. According to normal test results of the Bayley scales of infant development, the premature infants was then divided into abnormal neuropsychological development group (Mental development index, MDI≤79) and normal neuropsychological development group MDI(>79), and the data of two groups were statistically analyzed.Results:1. Among the clinical data, birth weight, premature rupture of membranes, neonatal asphyxia, RDS (Respiratory distress syndrome), apnea, MAS (Meconium aspiration syndrome), neonatal hypoglycemia, neonatal sepsis and extrauterine growth retardation of two groups had significant difference.2. The incidence rate of neonatal sepsis between the first child and the second child of twins has statistic significance in study group (P<0.05).3. The frequency distribution of MDI score in study group showed a skewed distribution, of which59%for abnormal neuropsychological development (MDI≤79); However,the frequency distribution of MDI score in control group showed a approximate normal distribution, of which only12%for abnormal neuropsychological development.4. Head circumference, body length, body weight, MDI, PDI(Psycho-motor development index) of twin premature infants were lower than which of the singleton premature infants, and the difference was statistically significant (P<0.05).5. The single factor analysis demonstrated that the risk factors of abnormal neuropsychological development(MDI≤79) of twin premature infants were gestational age, birth weight, mother’s gestational age, the cultural degree of parents, mode of feeding, neonatal hyperbilirubinemia, neonatal hypoglycemia and neonatal sepsis.6. Multiple regression analysis showed that neonatal hyperbilirubinemia was the independent risk factor of abnormal neuropsychological development of twin premature infants.Conclusion:1.The incidence of RDS, apnea, neonatal hypoglycemia, sepsis and EUGR (Extrauterine growth retardation) of twin premature infants were higher than the singleton premature infants in the neonatal period. But the incidence of newborn severe asphyxia and MAS has a higher rate in singleton premature infants.2. At same gestational age, neuropsychological development of twin premature infants lagged behind singleton premature infants.3. Neonatal hyperbilirubinemia is the risk factors of neuropsychological development of twin premature infants, so the early and aggressive treatment of neonatal hyperbilirubinemia may be beneficial for the neuropsychological development of twin premature infants.