Roccella M, Salonia G, Caponetto C, Romano G, Zocco A, Parisi L
Dipartimento di Psicologia, Università degli Studi di Palermo, Palermo, Italy.
Minerva Pediatr. 2004 Feb;56(1):97-107.
Several studies focus on the psychic development of extremely low birth weight (ELBW) preterm infants and highlight the presence of neurological, cognitive and relating disorders. Several contributions have in fact shown that in these subjects in school age disturbances of cognitive functions may be encountered; in particular, disturbances of specific neuropsychological functions, such as attention defects, impaired visuo-spatial function, memory and language have been reported in subjects with a globally normal intelligence quotient.
Forty-three school-aged children were studied (21 males and 22 females). They had a low birth weight (weight between 1,050-2,450 g), the gestation period was between 29 and 32 weeks and they were compared with a control sample whose birth weight was >2,500 g. Cognitive development was assessed by a test battery including WISC-R, Zazzo "deux Barrage" Test, Benton Visual Retention Test and Frostig Developmental Test of Visual Perception. Parents were also called in to evaluate how they had experienced the birth of their child and how long the mother had been kept in the clinic.
The overall analysis of our study suggests normal cognitive development in these children. No significant diffences were detected in the 2 studied groups. The lack of differences could be associated with the criteria used to select our sample because no children with severe perinatal disorders were included in the study. In addition, a good mother-child relationship seems to have been established in these children and this has certainly contributed to cognitive development adequate to their age.
The prognosis of these children is therefore closely related both to the birth weight and, especially, to the difficulties faced in the neonatal age (severe perinatal diseases).
多项研究聚焦于极低出生体重(ELBW)早产儿的心理发育,并强调存在神经、认知和社交障碍。事实上,多项研究表明,在这些学龄期儿童中可能会出现认知功能障碍;特别是,在智商总体正常的儿童中,已报告存在特定神经心理功能障碍,如注意力缺陷、视觉空间功能受损、记忆和语言障碍。
对43名学龄儿童进行了研究(21名男性和22名女性)。他们出生体重低(体重在1050 - 2450克之间),妊娠期在29至32周之间,并与出生体重>2500克的对照样本进行比较。通过包括韦氏儿童智力量表修订版(WISC - R)、扎佐“双障碍”测试、本顿视觉保持测试和弗罗斯蒂格视觉感知发育测试在内的一组测试来评估认知发育。还邀请家长评估他们对孩子出生的体验以及母亲在诊所住院的时长。
我们研究的总体分析表明这些儿童认知发育正常。在两个研究组中未检测到显著差异。差异不明显可能与我们选择样本的标准有关,因为研究中未纳入患有严重围产期疾病的儿童。此外,这些儿童似乎已建立了良好的母婴关系,这无疑有助于他们达到与其年龄相适应的认知发育。
因此,这些儿童的预后与出生体重密切相关,尤其是与新生儿期面临的困难(严重围产期疾病)密切相关。