極低出生體重早產兒之氣質特徵與發展之關係

Relationship of Temperamental Characteristics to Development in Very Low Birth Weight Infants

鄒國蘇(Kuo-Su Tsou) ； 鄒國英(Kuo-Inn Tsou) ； 鄭素芳(Suh-Fang Jeng) ； 許瓊心(Chyong-Hsin Hsu) ； 方麗容(Li-Jung Fang)

《北市醫學雜誌》 2卷8期 (2005/08) Pp. 722-731

https://doi.org/10.6200/TCMJ.2005.2.8.05

摘要

目的：了解大台北地區極低出生體重早產兒之氣質特徵，及其與面理、動作等各項發展間的相關性，並以此作為預防醫療及早期療育之臨床參考。方法：針對84-85年出生於臺大醫院、台北馬偕紀念醫院、台北市立婦幼醫院的極低出生體重早產兒239名及對照組足月正常出生體重兒85名進行前瞻性追蹤，於矯正年齡3歲時施以貝萊嬰幼兒發展測驗、學齡前兒童發展評估及兒童氣質評量。結果：極低出生體重早產兒比對照組活動量較高、較敏感、堅持度較低，且此三項氣質特徵和貝萊嬰幼兒發展測驗心理、動作量表分數及學齡前兒童發展量表中之語言、認知、環境理解、一般性發展均呈顯著負相關。另外，規律性亦和貝萊嬰幼兒發展測驗心理、動作量表分數及語言認知等發展相關達顯著。結論：極低出生體重早產兒之氣質特徵和對照組有顯著不同，且這些相異的氣質特徵和多項發展有顯著相關。故在幼兒期定期作氣質評量，並針對不利於發展之氣質特徵提供適當的諮商指導，是醫療人員對此類發展障礙高危險兒童及其家長相當實際有效的幫助。

關鍵字

極低出生體重早產兒 ； 氣質特徵 ； 發展 ； 發展障礙高危險兒童

並列摘要

Background and purpose: This study aimed to investigate temperament characteristics and their relationship to the mental and motor development of very low birth weight (VLBW) infants. Methods: A total of 239 infants born at the Women and Children's Taipei City Hospital, National Taiwan University Hospital and Taipei MacKay Memorial Hospital during 1985-1986 with birth weights under 1,501 gm were recruited prospectively as the case group. Eighty three full term infants, with appropriate birth weights, were recruited as a control group. The Bayley Scales of Infant Development (BSID) 2(superscript nd) ed., Chinese Child Development Inventory (CCDI) and New York Longitudinal Study (NYLS) 3-7 year-old Children's Temperament Questionnaire were performed at age three years. Results: There were significant differences in temperament characteristics between the two groups. The VLBW infants had higher activity levels, lower persistence and lower thresholds. These three items also correlated significantly with the Mental Development Index (MDI) scores, Psychomotor Development Index (PDI) scores and CCDI scores in language, cognition, personal-social and general development, with the exception that activity had no contribution to the PDI score. Furthermore, rhythmicity also had significant correlation with the MDI and PDI scores, and CCDI scores in language and personal-social categories. There were fewer temperament characteristics that correlated significantly with MDI, PDI and CCDI categories in the control group. Conclusions: The temperament characteristics of VLBW infants correlate significantly with their mental and motor development Therefore, early assessment of development and temperament among these VLBW infants, in order to provide proper early intervention, is mandatory to offset adverse outcomes.

並列關鍵字

very low birth weight ； temperament ； development