CAJ | 학술논문

背景:先兆流产是一种高风险的妊娠期病变,通常采用的各种医学方法,具有很好的保胎作用,但在保留一个新生命的同时,是否能保证新生儿全面健康的发展,尤其是对于具有长期影响作用的智慧能力的正常发展,会产生何种效应,是值得探讨研究的一个重要问题.目的:了解先兆流产保胎儿童智力水平与正常足月顺产儿童的差异,及其影响因素.设计:以儿童为研究对象的病例-对照研究,观察对比研究.单位:一所师范大学的心理学系、一所区级妇幼保健院的妇儿科.对象:母亲有妊娠期先兆流产病史,经保胎足月顺产的5～7岁儿童170名;同期出生,母亲无妊娠期先兆流产病史,正常足月顺产的5～7岁儿童182名.两类受测对象均无影响其智慧能力发展的其他情况.方法:采用中国韦氏幼儿智力量表(C-WYCSI,适用于6岁以下儿童),韦氏儿童智力量表(WISC-CR,适用于6岁以上儿童,含6岁儿童),由受过训练的心理系三年级学生,对每个受测者作个别测验.主要观察指标:①两类受测儿童智力发展水平(智力测验所测得的智商分数).②性别、年龄和出生体质量、母亲的怀孕年龄对两类受测儿童智力发展水平的影响.结果:①未发现典型的智力落后或智力超常的儿童,所有受测儿童的智商分数都在正常范围(100±2SD,SD=15)之内;②先兆组儿童的智商平均分数明显低于正常组,差异有显著性意义(P<0.01);③多因素方差分析结果显示,母亲是否有先兆流产,与儿童的性别、出生体质量,以及母亲的怀孕年龄等这些因素,具有显著的交互作用:母亲经历先兆流产,更容易造成新生儿体质量较低(先兆组低体质量儿占本组受测者的28%,是本次测查低体质量儿总数的66%),也更有可能造成男童的智慧能力发展水平较低(两组男童智商分数间的差异显著,F=2.809,P<0.05);尤其是35岁以上高龄孕妇的先兆流产经历,对儿童智慧能力的发展具有更大的负面影响(32名受测儿童的平均智商分数为86).结论:孕妇先兆流产可能是影响儿童智慧能力发展的一个潜在的先天因素.对于有这类经历的高危个案,有必要尽早做好早期干预工作,创造良好的物质、文化环境,避免智力落后的真正发生. 揹景:先兆流產是一種高風險的妊娠期病變,通常採用的各種醫學方法,具有很好的保胎作用,但在保留一箇新生命的同時,是否能保證新生兒全麵健康的髮展,尤其是對于具有長期影響作用的智慧能力的正常髮展,會產生何種效應,是值得探討研究的一箇重要問題.目的:瞭解先兆流產保胎兒童智力水平與正常足月順產兒童的差異,及其影響因素.設計:以兒童為研究對象的病例-對照研究,觀察對比研究.單位:一所師範大學的心理學繫、一所區級婦幼保健院的婦兒科.對象:母親有妊娠期先兆流產病史,經保胎足月順產的5～7歲兒童170名;同期齣生,母親無妊娠期先兆流產病史,正常足月順產的5～7歲兒童182名.兩類受測對象均無影響其智慧能力髮展的其他情況.方法:採用中國韋氏幼兒智力量錶(C-WYCSI,適用于6歲以下兒童),韋氏兒童智力量錶(WISC-CR,適用于6歲以上兒童,含6歲兒童),由受過訓練的心理繫三年級學生,對每箇受測者作箇彆測驗.主要觀察指標:①兩類受測兒童智力髮展水平(智力測驗所測得的智商分數).②性彆、年齡和齣生體質量、母親的懷孕年齡對兩類受測兒童智力髮展水平的影響.結果:①未髮現典型的智力落後或智力超常的兒童,所有受測兒童的智商分數都在正常範圍(100±2SD,SD=15)之內;②先兆組兒童的智商平均分數明顯低于正常組,差異有顯著性意義(P<0.01);③多因素方差分析結果顯示,母親是否有先兆流產,與兒童的性彆、齣生體質量,以及母親的懷孕年齡等這些因素,具有顯著的交互作用:母親經歷先兆流產,更容易造成新生兒體質量較低(先兆組低體質量兒佔本組受測者的28%,是本次測查低體質量兒總數的66%),也更有可能造成男童的智慧能力髮展水平較低(兩組男童智商分數間的差異顯著,F=2.809,P<0.05);尤其是35歲以上高齡孕婦的先兆流產經歷,對兒童智慧能力的髮展具有更大的負麵影響(32名受測兒童的平均智商分數為86).結論:孕婦先兆流產可能是影響兒童智慧能力髮展的一箇潛在的先天因素.對于有這類經歷的高危箇案,有必要儘早做好早期榦預工作,創造良好的物質、文化環境,避免智力落後的真正髮生.
배경:선조유산시일충고풍험적임신기병변,통상채용적각충의학방법,구유흔호적보태작용,단재보류일개신생명적동시,시부능보증신생인전면건강적발전,우기시대우구유장기영향작용적지혜능력적정상발전,회산생하충효응,시치득탐토연구적일개중요문제.목적:료해선조유산보태인동지력수평여정상족월순산인동적차이,급기영향인소.설계:이인동위연구대상적병례-대조연구,관찰대비연구.단위:일소사범대학적심이학계、일소구급부유보건원적부인과.대상:모친유임신기선조유산병사,경보태족월순산적5～7세인동170명;동기출생,모친무임신기선조유산병사,정상족월순산적5～7세인동182명.량류수측대상균무영향기지혜능력발전적기타정황.방법:채용중국위씨유인지역량표(C-WYCSI,괄용우6세이하인동),위씨인동지역량표(WISC-CR,괄용우6세이상인동,함6세인동),유수과훈련적심리계삼년급학생,대매개수측자작개별측험.주요관찰지표:①량류수측인동지력발전수평(지력측험소측득적지상분수).②성별、년령화출생체질량、모친적부잉년령대량류수측인동지력발전수평적영향.결과:①미발현전형적지력락후혹지력초상적인동,소유수측인동적지상분수도재정상범위(100±2SD,SD=15)지내;②선조조인동적지상평균분수명현저우정상조,차이유현저성의의(P<0.01);③다인소방차분석결과현시,모친시부유선조유산,여인동적성별、출생체질량,이급모친적부잉년령등저사인소,구유현저적교호작용:모친경력선조유산,경용역조성신생인체질량교저(선조조저체질량인점본조수측자적28%,시본차측사저체질량인총수적66%),야경유가능조성남동적지혜능력발전수평교저(량조남동지상분수간적차이현저,F=2.809,P<0.05);우기시35세이상고령잉부적선조유산경력,대인동지혜능력적발전구유경대적부면영향(32명수측인동적평균지상분수위86).결론:잉부선조유산가능시영향인동지혜능력발전적일개잠재적선천인소.대우유저류경력적고위개안,유필요진조주호조기간예공작,창조량호적물질、문화배경,피면지력락후적진정발생.
BACKGROUND: Threatened abortion is a high risk pathological change during gestation. Fetus usually could be protected after the application of all kinds of medical interventions; however, whether the healthy development of the newborn could be assured simultaneously when a new life is protected?Especially the long-term impact on the normal development of the intelligence is an important issue deserving investigation.OBJECTIVE: To investigate the differences of intelligence level between protected fetus after threatened abortion and normal mature fetus, and the influencing factors.DESIGN: A case-controlled observational comparative study introducing children as the subjects.SETTINGS: Psychological department of a normal university; Department of gynecology and pediatrics of a district women and children' s health care hospital.PARTICIPANTS: Totally 170 children(mature and natural delivery after protection) of 5 to 7 years old, whose mothers experienced threatened abortions during gestation, and 182 children born in the same period(normal mature and natural delivery) of 5 to 7 years old, whose mothers did not have threatened abortion history were selected as the subjects. No other factors would affect the intellectual development in the subjects of both groups.INTERVENTIONS: The Chinese Version of Wechsler young children scale of intelligence(C-WYCSI) for children below 6 years old or Wechsler intelligence scale for children-Chinese revision( WISC-CR ) for children no younger than 6 years old were introduced in the individual test performed by trained psychological junior students for every testee.children in both groups [intelligence quotient(IQ) gained in the intelligence of mother on the intellectual development of the children in both groups.was found in the testees, the IQ of all tested children was within the normal dren was sinificantly lower in the threatened abortion group than in the normal were significant interactions between threatened abortion and gender, body mass at birth and the pregnant age of mother, etc.: if the mother experienced threatened abortion, the newborn would be even more easily to suffer from relative low body mass at birth(low body mass fetus accounted for 28% of threatened abortion group, which accounted for about 66% of the total low body mass at birth fetuses in our study); the male newborn would be even more easily to have relative low intellectual development(the difference of IQ between the male children of two groups was significant) (F = 2. 809, P < 0.05). Especially, the negative impact on children' s intellectual development would be even greater if the pregnant woman were older than 35 years old and had threatened abortion experience(the average IQ of 32 tested children was 86).CONCLUSION: Threatened abortion might be a potential innate factor that would affect the intellectual development of the children. For those high-risk individual cases with this kind of experience, early intervention should be prepared as early as possible to create a favorable substantial and culture environment for avoiding the actual occurrence of delayed intelligence.