Aylward Glen P
Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9658, USA.
Ment Retard Dev Disabil Res Rev. 2002;8(4):234-40. doi: 10.1002/mrdd.10043.
Improved survival in preterm infants has broadened interest in cognitive and neuropsychological outcomes. The incidence of major disabilities (moderate/severe mental retardation, neurosensory disorders, epilepsy, cerebral palsy) has remained consistent, but high prevalence/low severity dysfunctions (learning disabilities, ADHD, borderline mental retardation, specific neuropsychological deficits, behavioral disorders) have increased. The follow-up literature contains methodologic problems that make generalizations regarding outcome difficult, and these are discussed. Although mean IQs of former VLBW infants generally are in the low average range and are 3-9 points below normal birth weight peers, these scores mask subtle deficits in: visual-motor and visual-perceptual abilities, complex language functions, academics (reading, mathematics, spelling and writing), and attentional skills. There is an increased incidence of non-verbal learning disabilities, need for special educational assistance, and behavioral disorders in children born prematurely. Males have more problems, and there is a trend for worsening outcome over time, due to emergence of more subtle deficits in response to increased performance demands. In addition to IQ and achievement testing in follow-up, there should be evaluation of executive functions and attention, language, sensorimotor functions, visuospatial processes, memory and learning, and behavioral adjustment.
早产儿存活率的提高引发了人们对其认知和神经心理结果的广泛关注。严重残疾（中度/重度智力迟钝、神经感觉障碍、癫痫、脑瘫）的发生率一直保持稳定，但高患病率/低严重程度的功能障碍（学习障碍、注意力缺陷多动障碍、边缘智力迟钝、特定神经心理缺陷、行为障碍）有所增加。后续研究文献存在方法学问题，这使得对结果进行归纳总结变得困难，文中对此进行了讨论。尽管极低出生体重儿的平均智商通常处于低平均水平，比正常出生体重的同龄人低3至9分，但这些分数掩盖了以下方面的细微缺陷：视觉运动和视觉感知能力、复杂语言功能、学业能力（阅读、数学、拼写和写作）以及注意力技能。早产儿童中非言语学习障碍、需要特殊教育援助以及行为障碍的发生率有所上升。男性面临的问题更多，而且随着时间推移，由于在更高的表现要求下出现了更细微的缺陷，结果有恶化的趋势。在后续随访中，除了进行智商和学业成绩测试外，还应评估执行功能、注意力、语言、感觉运动功能、视觉空间处理、记忆和学习以及行为调整。
