Observation Of Early Mental Development In High Risk Infants

Objective:Dynamic monitoring the early mental development scores of full-term neonates with high risk factors, such as fetal distress, mild asphyxia and hyperbilirubinemia without bilirubin encephalopathy, which compared with normal neonates. Discuss the influence of above risk factors for early mental development and the necessity of dynamic monitoring for the mental development.Method:1. The object of study and experimental groups:310cases of full-term neonates born in ZhuZhou Central Hospital were selected meeting the inclusion criteria and complete follow-up to6months after birth from June2012to March2013. Exclusion criteria:severe asphyxia, congenital malformation, genetic and metabolic diseases, intrauterine infection, sepsis and bilirubin encephalopathy, as well as excepting for the cases deviating from the normal growth and suffering from serious diseases.76cases neonates of fetal distress born without intrapartum asphyxia, called fetal distress group;54cases neonates of mild asphyxia, called mild asphyxia group;75cases neonates of hyperbilirubinemia, called hyperbilirubinemia group; neonates in control group included105cases of neonate without high risk factors.2. The experimental data acquisition:establishing health files and collecting the name, gender, gestational age, birth weight, Apgar score at1minutes, Apgar score at5minutes, and set up the registration form for6months follow-up of the neonate. The follow-up time points were:full-term neonates born after7days,3months,6months. Nervous system evaluated by NBNA, CDCCscale, Child heart scale.3. Statistical methods:All data were presented as mean±standard deviation (x±S). Student’s t test was performed to detect differences of means between the two groups and chi-square (X2) test for proportion differences. Correlation analysis was utilized to study correlations between two indexes. SPSS13.0for Windows statistical packages were used for data analysis. A significant difference was assumed at P＜0.05.Result:1. NBNA score at7days of age:fetal distress group was significantly lower than the control group (t=4.89, P＜0.01); mild asphyxia group was significantly lower than control group (t=18.53, P＜0.01); mild asphyxia group was significantly lower than fetal distress group (t=11.47, P＜0.01); hyperbilirubinemia group was significantly lower than control group (t=4.92, P＜0.01). There were statistical significances between above comparative groups.2. CDCC scale at3months of age:the MDI (t=6.29, P＜0.01) and PDI (t=4.79, P＜0.01) scores in fetal distress group were significantly lower than control group; the MDI (t=15.96, P＜0.01) and PDI (t=13.06, P＜0.01) scores in mild asphyxia group were significantly lower than control group; the MDI (t=10.91, P＜0.01) and PDI (t=9.5, P＜0.01) in mild asphyxia group were significantly lower than the fetal distress group (P＜0.01); the MDI (t=6.02, P＜0.01) and PDI (t=5.17, P＜0.01) scores in hyperbilirubinemia group were significantly lower than control group. There were statistical significances between above comparative groups.3. Child heart scale at6months of age:the scores of group big action (t=7.40, P＜0.01), fine motor (t=5.33, P＜0.01), adaptive capacity (t=7.38, P＜0.01), language (7=5.66, P＜0.01) and social ability (t=4.68, P＜0.01) in fetal distress group were significantly lower than control group; the scores of big action (t=13.60, P＜0.01), fine motor (t=9.25, P＜0.01), adaptive capacity (t=11.38, P＜0.01), language (t=11.81, P＜.01) and social ability (t=8.68, P＜0.01) in mild asphyxia group were significantly lower than control group; the scores of big action (t=4.48, P＜0.01), fine motor (t=3.31, P＜0.01), adaptive capacity (t=3.50, P＜0.01), language(t=5.36, P＜0.01) and social ability (t=4.06, P＜0.01) in asphyxia group were significantly lower than fetal distress group; the scores of big movement (t=3.46, P＜0.01), adaptive capacity (t=1.98, P＜0.05) in hyperbilirubinemia group were significantly lower than control group, but there was no significant difference in the score of fine motor, language and social ability scores between the two groups (P>0.05).4. There were positive correlation between NBNA score at7days of age with CDCC (MDI, PDI) scores at3months of age and Child heart scale score at6 month of age in high risk infants (P<0.01)Conclusion:1. Fetal distress, mild asphyxia had obvious effect on early mental devopment of full-term neonates.The effects of mild asphyxia might be more obvious.2. Hyperbilirubinem without bilirubin encephalopathy also had effect on early mental devopment.3. There were positive correlation between NBNA score at7days of age with CDCC (MDI, PDI) scores at3months of age and Child heart scale score at6month of age in high risk infants, and it was necessary to monitor the early mental devopment for full-term high risk infants with fetal distress, mild asphyxia and hyperbilirubinem without bilirubin encephalopathy.