Pietz Joachim, Peter Johannes, Graf Rainer, Rauterberg-Ruland Inge, Rupp André, Sontheimer Dieter, Linderkamp Otwin
Department of Pediatric Neurology, University of Heidelberg, Im Neuenheimer Feld 150, D-69120 Heidelberg, Germany.
Early Hum Dev. 2004 Sep;79(2):131-43. doi: 10.1016/j.earlhumdev.2004.05.001.
Outcome studies on the effects of prematurity are increasingly restricted to extremely immature infants with birth weight below 1000 g or gestational age below 26 weeks. In contrast, studies comprising low-risk preterm infants are rare.
To examine growth and neurodevelopmental outcome, 70 low-risk low birth weight (LBW) children without neurological impairment were followed from birth to 7 years of age. At 7 years of age, LBW children were compared to a matched control group born at term.
Postnatal growth was measured at 20 months in the LBW group and at 7 years in LBW and control children. At 20 months, the LBW group was assessed with the Griffiths Scales. At 7 years, LBW and control children were assessed with a neuropsychological test battery comprising tests for language, visual-perceptual, visual-motor, fine and gross motor abilities.
At 7 years of age, the frequency of children with low (3rd-9th percentile) or subnormal (<3rd percentile) growth parameters was increased in the LBW group. The Mean Griffiths Developmental Quotient (DQ) of the preterm group was normal (102.3+/-8.4), and there were only two results below DQ 85. There was no difference between 49 children appropriate for gestational age and 21 small for gestational age (SGA) children. At 7 years of age, reduced mean test results in the range of -0.5 SDS were observed for language and visual-motor abilities in the preterm group. This was due to an increased frequency of LBW children with moderately (SDS -1.0 to -2.0 SDS) subnormal test results. Even for the slightly LBW group (2000 to 2499 g), poorer language abilities were confirmed.
All LBW infants, including low-risk populations, should be included in a follow-up program in order to detect deficits early in life and begin treatment before school entry.
关于早产影响的结局研究越来越局限于出生体重低于1000克或胎龄低于26周的极不成熟婴儿。相比之下，纳入低风险早产儿的研究很少。
为了研究生长和神经发育结局，对70名无神经功能障碍的低风险低出生体重（LBW）儿童从出生至7岁进行了随访。在7岁时，将LBW儿童与足月出生的匹配对照组进行比较。
在LBW组20个月时以及LBW组和对照组儿童7岁时测量出生后生长情况。在20个月时，用格里菲斯量表对LBW组进行评估。在7岁时，用包括语言、视觉感知、视觉运动、精细和粗大运动能力测试的神经心理测试组合对LBW组和对照组儿童进行评估。
在7岁时，LBW组生长参数低（第3至第9百分位数）或低于正常（<第3百分位数）的儿童频率增加。早产组的平均格里菲斯发育商（DQ）正常（102.3±8.4），只有两个结果低于DQ 85。适于胎龄的49名儿童和小于胎龄（SGA）的21名儿童之间没有差异。在7岁时，早产组在语言和视觉运动能力方面观察到平均测试结果降低了-0.5 SDS。这是由于LBW儿童中度（SDS -1.0至-2.0 SDS）低于正常测试结果的频率增加。即使对于轻度LBW组（2000至2499克），也证实其语言能力较差。
所有LBW婴儿，包括低风险人群，都应纳入随访计划，以便在生命早期发现缺陷并在入学前开始治疗。
