Neurodevelopmental Trajectories of 1351 Small for Gestational Age Infants at (Corrected) 6~24 Months of Age

目的：探讨小于胎龄儿(small for gestational age, SGA)(校正) 6~24月龄神经心理发育轨迹。方法：收集2018年4月至2023年12月在深圳市宝安区妇幼保健院高危儿随访门诊定期随访的1351例(校正) 6~24月龄SGA儿童随访期间资料，采用《中国0~6岁儿童神经心理行为检查量表(2016版)》评估神经心理发育水平，根据出生胎龄将SGA分为足月儿组、低危早产儿组和高危早产儿组，调查不同胎龄SGA儿童发育商(developmental quotient, DQ)水平并绘制神经发育曲线。结果：各胎龄组SGA的大运动DQ均随月龄增加而上升(P均0.05)，精细运动能区DQ一直处于临界偏低状态。在(校正) 6~17月龄，SGA总DQ随着胎龄下降而降低(P均0.05)，而高危早产SGA的总DQ和大运动、精细运动、适应能力DQ均落后于足月SGA (P均Objective: To investigate the neuropsychological developmental trajectory of small for gestational age (SGA) infants during (corrected) 6~24 months of age. Methods: Data were collected during the follow-up period of 1351 cases (corrected) of SGA infants aged 6~24 months who were regularly followed up at the high-risk infant follow-up clinic of Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China, from April 2018 to December 2023. Neuropsychological Behavioral Examination Scale for Children 0~6 Years of Age (2016 version) was used to assess the level of neuropsychological development. SGA infants were categorized into full-term, low-risk preterm and high-risk preterm groups according to birth gestational age. The developmental quotient (DQ) levels of SGA infants of different gestational ages were investigated and neurodevelopmental curves were drawn. Results: With the increase of age, DQ values of gross motor in all gestational age groups increased (P 0.05) except for gross motor skills, with the fine motor domain DQ persistently remaining at borderline-low levels. The values of total DQ decreased with the decrease of gestational age during (corrected) 6~17 months of age (P 0.05). The total DQ and DQs of gross motor, fine motor and adaptive ability in high-risk preterm SGA infants were all lower than those of full-term SGA infants (P < 0.05), and gross motor DQ was lower than those of low-risk preterm SGA (P = 0.049). Conclusions: The gross motor domain is the predominant developmental area in SGA infants. The total DQ of full-term and low-risk preterm SGA declined with increasing months of age, and the total DQ of high-risk preterm SGA infants remained stable but was at an overall low level, and neurodevelopmental management should be strengthened for SGA below 34 weeks.