Resnick M B, Roth J, Ariet M, Carter R L, Emerson J C, Hendrickson J M, Packer A B, Larsen J J, Wolking W D, Lucas M
College of Medicine, University of Florida, Gainesville 32610.
Pediatrics. 1992 Mar;89(3):373-8.
Studies of developmental outcome of neonatal intensive care unit graduates have generally been limited to the first 2 to 3 years of life, with outcome determined by psychometric tests. This study followed neonatal intensive care unit graduates born 1975 through 1983 (n = 457) into the public school system and compared their educational outcomes with those of newborn nursery graduates (n = 656). Outcomes were evaluated by placement in four academic categories: regular classroom, academic problems, speech/language impairment, and major impairment. Educational outcomes for children of both groups were essentially the same. Their placement in the four academic categories were equally affected by nonmedical variables, primarily income (below/above poverty level), race, and sex. Seventy percent of poverty-level children were in one of the three problem categories, compared with 40% of children above poverty level. Neither neonatal intensive care unit treatment nor low birth weight were major predictors of educational outcome. The only clear-cut neonatal intensive care unit effect occurred among children born with sensory or physical impairments. Therefore, in order to reduce poor educational outcomes, follow-up and intervention programs should be targeted primarily to children with diagnosable handicaps and from minority, low-income families.
对新生儿重症监护病房出院患儿发育结局的研究通常局限于生命的最初2至3年，结局由心理测试来判定。本研究追踪了1975年至1983年出生的新生儿重症监护病房出院患儿（n = 457）直至其进入公立学校系统，并将他们的教育结局与新生儿病房出院患儿（n = 656）进行比较。结局通过四个学业类别进行评估：常规课堂、学业问题、言语/语言障碍和严重障碍。两组儿童的教育结局基本相同。他们在四个学业类别中的分布同样受到非医学变量的影响，主要是收入（贫困线以下/以上）、种族和性别。70%的贫困线以下儿童属于三个问题类别之一，相比之下，贫困线以上儿童的这一比例为40%。新生儿重症监护病房的治疗和低出生体重都不是教育结局的主要预测因素。唯一明确的新生儿重症监护病房效应出现在伴有感觉或身体损伤的患儿中。因此，为了减少不良教育结局，随访和干预项目应主要针对有可诊断残疾的儿童以及来自少数族裔、低收入家庭的儿童。
