Houtzager B A, Hogendoorn S M, Papatsonis D N M, Samsom J F, van Geijn H P, Bleker O P, van Wassenaer A G
Pediatric Psychosocial Department, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
BJOG. 2006 Mar;113(3):324-31. doi: 10.1111/j.1471-0528.2006.00851.x.
To compare the long-term psychosocial and motor effects on children exposed in utero to nifedipine or ritodrine for the management of preterm labour.
Randomised controlled trial.
Multicentre study in two university and one primary hospital in the Netherlands.
In the original trial, 185 women were randomised to either nifedipine (n = 95) or ritodrine (n = 90). Of the 185 liveborn children, 171 survived (92%), and of these 102 (61%) were followed up at age 9-12 years.
Age-specific questionnaires were administered to the parent and teacher. Additional data were obtained from medical records.
Questionnaires were used to assess the child's behavioural-emotional problems, quality of life (QoL), motor functioning, parenting distress and the child's education.
Of the 171 eligible families, 102 (61%) agreed to participate and completed the questionnaires. Response was equal in the ritodrine group (n = 54 of 83 surviving children, 65%) compared with the nifedipine group (n= 48 of 88 surviving children, 55%). After controlling for differing perinatal characteristics at birth, no significant differences between the groups were detected with respect to long-term behaviour-emotional outcome, QoL, education, motor functioning or parenting distress. Psychosocial outcome was slightly better in the nifedipine group.
The results do not support any differential postnatal effect of the tocolytic agents ritodrine or nifedipine on the child's long-term psychosocial and motor functioning. The slightly better outcome of children randomised in the nifedipine group is most likely due to more favourable perinatal outcomes in this group. These results merit further investigation in a larger group of survivors.
比较子宫内暴露于硝苯地平或利托君用于早产治疗的儿童的长期心理社会和运动影响。
随机对照试验。
荷兰两所大学医院和一所基层医院的多中心研究。
在原试验中，185名妇女被随机分为硝苯地平组（n = 95）或利托君组（n = 90）。185名活产儿中，171名存活（92%），其中102名（61%）在9至12岁时接受了随访。
向家长和教师发放特定年龄的问卷。从医疗记录中获取其他数据。
问卷用于评估儿童的行为情绪问题、生活质量（QoL）、运动功能、育儿困扰和儿童教育情况。
在171个符合条件的家庭中，102个（61%）同意参与并完成了问卷。利托君组（83名存活儿童中的54名，65%）与硝苯地平组（88名存活儿童中的48名，55%）的应答率相当。在控制出生时不同的围产期特征后，两组在长期行为情绪结局、生活质量、教育、运动功能或育儿困扰方面未发现显著差异。硝苯地平组的心理社会结局略好。
结果不支持宫缩抑制剂利托君或硝苯地平对儿童长期心理社会和运动功能有任何产后差异影响。硝苯地平组随机分组儿童的结局略好，很可能是由于该组围产期结局更有利。这些结果值得在更大规模的存活者群体中进一步研究。
