Msall Michael E, Phelps Dale L, Hardy Robert J, Dobson Velma, Quinn Graham E, Summers C Gail, Tremont Michelle R
Pritzker School of Medicine, University of Chicago, Comer Children's and La Rabida Children's Hospitals, Chicago, Illinois, USA.
Pediatrics. 2004 Apr;113(4):790-9. doi: 10.1542/peds.113.4.790.
To describe the educational status and special education services at 8 years among children who had threshold retinopathy of prematurity (ROP).
A prospective study was conducted of a cohort of children who had birth weight of <1251 g and threshold ROP in the Cryotherapy for Retinopathy of Prematurity multicenter study. At age 5.5 years, visual status, functional skills, and social information were obtained. At 8 years, special education classes, developmental disabilities, rehabilitation therapies, and academic and social competencies were determined by questionnaire. Visual status was considered favorable/unfavorable on the basis of the better eye.
Of 255 survivors, 216 (85%) were evaluated at both 5.5 and 8 years. Major impairments were significantly more prevalent in children with unfavorable versus favorable visual status: cerebral palsy (39% vs 16%), developmental disability (57% vs 22%), autism (9% vs 1%), and epilepsy (23% vs 3%). Special education services (63% vs 27%), below-grade-level academic performance (84% vs 48%), and school-based rehabilitation services were significantly less common in children with favorable visual status. Favorable visual status, favorable functional ratings at 5.5 years, markers of higher socioeconomic status, and nonblack race were associated with significantly lower rates of both special education placement and below-grade-level academic performance at age 8. On multivariate logistic regression, only favorable visual status and functional status remained significant predictors for decreasing special education placement.
Threshold ROP is associated with high rates of developmental, educational, and social challenges in middle childhood; preserved vision was associated with a clear advantage, with more than half of the children with favorable visual status performing at grade level.
描述患有阈值早产儿视网膜病变（ROP）的儿童在8岁时的教育状况和特殊教育服务情况。
对早产儿视网膜病变冷冻治疗多中心研究中出生体重<1251 g且患有阈值ROP的一组儿童进行前瞻性研究。在5.5岁时，获取视觉状况、功能技能和社会信息。在8岁时，通过问卷调查确定特殊教育课程、发育障碍、康复治疗以及学业和社交能力。根据较好眼的情况将视觉状况分为良好/不良。
在255名幸存者中，216名（85%）在5.5岁和8岁时均接受了评估。与视觉状况良好的儿童相比，视觉状况不良的儿童中主要障碍的患病率显著更高：脑瘫（39%对16%）、发育障碍（57%对22%）、自闭症（9%对1%）和癫痫（23%对3%）。视觉状况良好的儿童接受特殊教育服务的比例（63%对27%）、学业成绩低于年级水平的比例（84%对48%）以及校内康复服务的比例显著更低。良好的视觉状况、5.5岁时良好的功能评分、较高的社会经济地位指标以及非黑人种族与8岁时特殊教育安置率和学业成绩低于年级水平的发生率显著较低相关。在多因素逻辑回归分析中，只有良好的视觉状况和功能状况仍然是减少特殊教育安置的显著预测因素。
阈值ROP与儿童中期发育、教育和社会挑战的高发生率相关；保留视力具有明显优势，超过一半视觉状况良好的儿童学业成绩达到年级水平。
