Influencing factors of the neurodevelopment of high-risk infants

BACKGROUND: High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants’ quality of life. AIMS: To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of high-risk infants. METHODS: High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up. The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment (0–2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted. RESULTS: 484 high-risk infants (male 51%, female 49%) with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was 2.1 (0.8) months, and the developmental quotient (DQ) scores of full-term high-risk infants in motor (t=3.542, p=0.001), cognitive (t=3.125, p=0.002), language (t=3.189, p=0.002) and social (t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor (χ(2) =9.452, p=0.002), cognitive (χ (2) =6.258, p=0.012), language (χ (2) =12.319, p =0.001) and social (χ (2) =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%. CONCLUSION: The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment. Monitoring and early interventions help to improve high-risk infants’ neurodevelopment.