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小于胎龄儿——直至成年期的躯体、神经及认知发育

[Small for gestational age - Somatic, neurological and cognitive development until adulthood].

作者信息

Kutschera J, Urlesberger B, Maurer U, Müller W

机构信息

Klinische Abteilung für Neonatologie, Univ.-Klinik für Kinder- und Jugendheilkunde Graz, Germany.

出版信息

Z Geburtshilfe Neonatol. 2002 Apr;206(2):65-71. doi: 10.1055/s-2002-30139.

Abstract

BACKGROUND

The somatic, neurological and cognitive development of children born small for gestational age (SGA) until adulthood was assessed in recent studies. Studies that assessed mortality, morbidity, somatic, neurological and cognitive development of SGA children were compared.

MATERIALS AND METHODS

In the studies very low birth weight SGA children were compared to very low birth weight appropriate for age children (AGA, birth weight below 1500 g or 1250 g). Full-term SGA children were compared to full-term appropriate for age children. Growth of SGA children remained under the 10th percentile, if catch up growth did not occur until the end of the second year. Cerebral palsy appeared more often in VLBW-AGA than in VLBW-SGA children. Cognitive development problems appeared in VLBW-SGA and FT-SGA children more often than in VLBW-AGA and FT-AGA children. These cognitive development problems were observed mainly as poor school performance. When reaching adulthood, the differences in cognitive function seem to be less significant. Low socioeconomic status and persistence of microcephaly were associated with problems in neurological and cognitive development.

CONCLUSIONS AND DISCUSSION

Growth and cognitive development problems appeared more often in SGA children. More longterm studies are necessary to show, if these cognitive development problems remain significant until adulthood.

摘要

背景

近期研究评估了小于胎龄儿(SGA)直至成年期的躯体、神经和认知发育情况。对评估SGA儿童死亡率、发病率、躯体、神经和认知发育的研究进行了比较。

材料与方法

在这些研究中,将极低出生体重的SGA儿童与极低出生体重的适龄儿童(AGA,出生体重低于1500克或1250克)进行比较。将足月SGA儿童与足月适龄儿童进行比较。如果SGA儿童在第二年结束时仍未出现追赶生长,其生长情况将维持在第10百分位数以下。极低出生体重AGA儿童患脑瘫的几率高于极低出生体重SGA儿童。极低出生体重SGA儿童和足月SGA儿童出现认知发育问题的几率高于极低出生体重AGA儿童和足月AGA儿童。这些认知发育问题主要表现为学业成绩不佳。成年后,认知功能的差异似乎不那么显著。社会经济地位低下和小头畸形持续存在与神经和认知发育问题有关。

结论与讨论

SGA儿童出现生长和认知发育问题的几率更高。需要更多长期研究来表明这些认知发育问题在成年期是否仍然显著。

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