巨大儿与足月适于胎龄儿2岁以内的体格及智能发育的对照研究

目的：了解出生体重对婴儿早期体格及智能发育的影响,为巨大儿的早期保健及健康教育提供理论依据。方法：在我院2007年1月～2009年12月出生的巨大儿及足月适于胎龄儿中,随机选取50例足月巨大儿作为观察组（除外生后低血糖、窒息、高胆红素血症者）,及50例与之匹配的足月适于胎龄儿作为对照组。两组孕周、生后评分、性别比例、父母收入、喂养方式比较差异无统计学意义。定期检查和记录两组的各体格及智能发育评估指标,了解两组婴儿体重指数及智能发育特点,采用Gesell发育诊断量表对两组进行评价。结果：观察组出生后3、6、9、12、18、24个月的超重发生率均显著高于对照组,差异均有统计学意义（P〈0.05）,观察组随年龄增长体重指数有下降趋势,6月龄时体重指数最高,24月时最低；观察组6月时大运动发育商数为（100.86±3.34）,对照组则为（104.58±3.19）,差异有统计学意义（P〈0.05）,12月时,观察组的发育商数已接近正常,两组大运动、精细运动、适应行为、语言和个人-社会性行为5个方面的的差异均无统计学意义（P〉0.05）。结论：巨大儿在2岁以内的体重指数显著高于足月适于胎龄儿；较重的体重负荷可对其生后6月内的大运动造成不良影响。

Control Study on the Physical and Mental Development of Macrosomiaand Term Infants Appropriate for Gestational Within Two Years Old

Objective： To explore the influence of birth weight of infants on early physical and mental development, and provide scientific evidences for early health care and education of macrosomia. Methods： The physical and mental development characteristics of the two groups in different periods were selected by regular tracing the macrosomia and term infants appropriate for gestational age（AGA）who were born in Qingdao municipal hospital between January 2007 and December 2009. None of them had hypoglycemia,suffocation and hyperbilirubinemia. The diference of gestational weeks after birth, score, gender ratio, parents income, feeding in two groups had no statistical difference. Body mass index（BMI）were assessed at 6 growth development to monitoring time for macrosomia and AGA. And mental development of two infant groups were evaluated during two years old by using Gesell developmental diagnosis scale. Results： The overweight rate of the macrosomia under two years old was 10.48%, in the control group was 4.68%（P〈0.05）.Developing quotient（DQ） of big motor development of macrosomia was 100.86±3.34, while 104.58±3.19 in AGA group at 6 months old（P0.05）. The developmental quotient of macrosomia was normal at twelve months old. The difference in other aspects was not significant. Conclusion： The BMI of normal macrosomia are significantly higher than those of term AGA under two years old. Heavier weight has significant effects on big motor development under 6 months old.