Saigal S, Hoult L A, Streiner D L, Stoskopf B L, Rosenbaum P L
Department of Pediatrics, McMaster University, Children's Hospital at Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada.
Pediatrics. 2000 Feb;105(2):325-31. doi: 10.1542/peds.105.2.325.
To compare measures of psychometric assessment and school difficulties in a cohort of extremely low birth weight (ELBW) teenagers and term controls, and to determine whether there is stability in psychometric measures between age 8 and the teen years.
Longitudinal follow-up; geographically defined region.
150 of 169 (89%) ELBW survivors born between 1977 and 1982 and 124 of 145 (86%) sociodemographically matched term controls between 12 and 16 years of age. Psychometric measures: Wechsler Intelligence Scale for Children-Revised, Wide Range Achievement Test-Revised, and a validated parent questionnaire.
Neurosensory impairments were present in 28% of ELBW and 1% of controls. The mean Wechsler Intelligence Scale for Children-Revised scores were ELBW: 89 +/- 19 and controls: 102 +/- 13. ELBW children did less well on Wide Range Achievement Test-Revised Reading, Spelling, and Arithmetic measures with mean scores in the range from 75 to 85. ELBW children <750 g were more disadvantaged, compared with those >/=750 g. A significantly higher proportion of ELBW children were receiving special educational assistance and/or had repeated a grade (ELBW: 58%; controls: 13%; odds ratio: 9.0). Paired analysis of within-cohort data at age 8 and teen years showed that for both cohorts Arithmetic scores declined, but there were small improvements in other measures, predominantly in the term children.
Differences of 13 to 18 points in psychometric measures in ELBW teens compared with controls are both statistically significant and clinically relevant. Decreasing birth weight was associated with increased risk on all measures. The high utilization of special educational resources has economic implications, and the incremental cost attributable to being extremely premature needs to be determined.
比较一组极低出生体重（ELBW）青少年和足月儿对照在心理测量评估及学业困难方面的指标，并确定8岁至青少年期心理测量指标是否具有稳定性。
纵向随访；地理界定区域。
1977年至1982年间出生的169名ELBW幸存者中的150名（89%），以及145名社会人口统计学匹配的足月儿对照中的124名（86%），年龄在12至16岁之间。心理测量指标：韦氏儿童智力量表修订版、广泛成就测验修订版，以及一份经验证有效的家长问卷。
28%的ELBW儿童存在神经感觉障碍，而对照组为1%。韦氏儿童智力量表修订版的平均得分ELBW组为89±19，对照组为102±13。ELBW儿童在广泛成就测验修订版的阅读、拼写和算术测量中表现较差，平均得分在75至85分之间。与出生体重≥750克的ELBW儿童相比，出生体重<750克的儿童处于更不利地位。接受特殊教育援助和/或留级的ELBW儿童比例显著更高（ELBW组：58%；对照组：13%；优势比：9.0）。对8岁和青少年期队列内数据的配对分析表明，两个队列的算术得分均下降，但其他测量指标有小幅改善，主要是足月儿。
ELBW青少年与对照组在心理测量指标上13至18分的差异在统计学上具有显著意义且具有临床相关性。出生体重降低与所有测量指标的风险增加相关。特殊教育资源的高利用率具有经济影响，需要确定因极度早产导致的额外成本。
