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极低出生体重儿12个月时的神经功能评估及36个月时的认知表现。

Twelve-month neurofunctional assessment and cognitive performance at 36 months of age in extremely low birth weight infants.

作者信息

Giannì Maria Lorella, Picciolini Odoardo, Vegni Chiara, Gardon Laura, Fumagalli Monica, Mosca Fabio

机构信息

Neonatal Intensive Care Unit, Institute of Pediatrics and Neonatology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena University Medical School, Milan, Italy.

出版信息

Pediatrics. 2007 Nov;120(5):1012-9. doi: 10.1542/peds.2006-3364.

Abstract

OBJECTIVE

The objective of this study was to investigate whether an early neurofunctional assessment (at 12 months' corrected age) is predictive of cognitive outcome at 36 months of age in extremely low birth weight infants.

METHODS

We conducted an observational longitudinal study. Neurodevelopmental outcome by means of a neurofunctional assessment was evaluated at 12 months' corrected age and 36 months' chronological age in 141 extremely low birth weight children. Cognitive outcome was assessed with use of the Griffiths Mental Developmental Scale.

RESULTS

A significant association was found between the 12-month neurofunctional status and cognitive performance at 36 months. A higher general quotient on the Griffiths Mental Developmental Scale at 36 months was observed in infants who exhibited normal (score: < or = 1) neurodevelopment compared with children who exhibited minor (score: 2) and major (score: > or = 3) dysfunctions at the 12-month neurofunctional evaluation (99 +/- 6.8 vs 85.3 +/- 16.3 vs 57.3 +/- 22.0). A score of > or = 2 at the 12-month neurofunctional assessment, abnormal brain MRI results at term, and chronic lung disease remained predictive of cognitive delay at 36 months of age and also after adjustment for confounders.

CONCLUSIONS

The 12-month neurofunctional evaluation may be an additional useful clinical tool in predicting later cognitive outcome in extremely low birth weight children.

摘要

目的

本研究的目的是调查早期神经功能评估(矫正年龄12个月时)是否能预测极低出生体重儿36个月时的认知结局。

方法

我们进行了一项观察性纵向研究。对141名极低出生体重儿童在矫正年龄12个月和实际年龄36个月时通过神经功能评估来评价神经发育结局。使用格里菲斯心理发展量表评估认知结局。

结果

发现12个月时的神经功能状态与36个月时的认知表现之间存在显著关联。在12个月神经功能评估中表现为正常(评分:≤1)的婴儿,与表现为轻度(评分:2)和重度(评分:≥3)功能障碍的儿童相比,36个月时在格里菲斯心理发展量表上的总商数更高(99±6.8 vs 85.3±16.3 vs 57.3±22.0)。12个月神经功能评估评分≥2、足月时脑MRI结果异常以及慢性肺病仍然是36个月时认知延迟的预测因素,在对混杂因素进行调整后也是如此。

结论

12个月时的神经功能评估可能是预测极低出生体重儿童后期认知结局的又一有用临床工具。

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