Stoelhorst G M S J, Martens S E, Rijken M, van Zwieten P H T, Zwinderman A H, Wit J M, Veen S
Department of Paediatrics, Leiden University Medical Centre, The Hague, The Netherlands.
Acta Paediatr. 2003 May;92(5):595-601.
The objective of this study was to determine behavioural outcome and risk factors for abnormal behaviour at 2 y corrected age in very premature infants in a regionally defined, prospective cohort study.
The Leiden Follow-Up Project on Prematurity includes all liveborn infants of < 32 wk gestational age, born in 1996/1997 (n = 266). Behaviour was assessed with the Child Behaviour Checklist 2-3.
An analysis of 158 questionnaires of 206 survivors (77%) was carried out. Fourteen children (9%) had a total problem score > p90 ("clinical range"). This percentage is comparable with the 10% found in a sample of 2- to 3-y-olds from the Dutch general population. Univariate analysis showed higher syndrome scale scores in one or more of the Child Behaviour Checklist scales in children of lower gestational age, small for gestational age (birthweight < p10), with neurological abnormalities at term or at 2 y and of non-Dutch origin. Lower socioeconomic status and postnatal treatment with dexamethasone were associated with higher scores in the somatic problems scale and lower maternal age at birth with a higher total problem score. After correction for confounding variables, the associations between small for gestational age, neurological abnormalities at 2 y and the anxious/depressed and/or withdrawn scales remained significant.
The prevalence of behavioural problems at 2 y corrected age in this cohort of very premature infants (gestational age < 32 wk) was comparable with that in a general population sample. Children born small for gestational age or with neurological abnormalities at 2 y of age had higher syndrome scale scores, mainly for anxious/depressed and/or withdrawn behaviour.
在一项区域界定的前瞻性队列研究中，本研究旨在确定极早产儿在矫正年龄2岁时的行为结局及异常行为的风险因素。
莱顿早产随访项目纳入了1996/1997年出生的所有孕周<32周的活产婴儿（n = 266）。使用儿童行为量表2 - 3对行为进行评估。
对206名幸存者（77%）中的158份问卷进行了分析。14名儿童（9%）的总问题得分>第90百分位数（“临床范围”）。该百分比与荷兰普通人群中2至3岁儿童样本中发现的10%相当。单因素分析显示，孕周较小、小于胎龄（出生体重<p10）、足月或2岁时存在神经异常以及非荷兰裔的儿童，在儿童行为量表的一个或多个量表中综合征量表得分较高。社会经济地位较低以及出生后接受地塞米松治疗与躯体问题量表得分较高相关，母亲生育时年龄较小与总问题得分较高相关。在对混杂变量进行校正后，小于胎龄、2岁时神经异常与焦虑/抑郁和/或退缩量表之间的关联仍然显著。
这一队列中极早产儿（孕周<32周）在矫正年龄2岁时行为问题的患病率与普通人群样本相当。小于胎龄出生或2岁时存在神经异常的儿童综合征量表得分较高，主要表现为焦虑/抑郁和/或退缩行为。
