Nomura Yoko, Rajendran Khushmand, Brooks-Gunn Jeanne, Newcorn Jeffrey H
Mount Sinai School of Medicine, Department of Psychiatry, New York, NY 10029USA.
J Child Psychol Psychiatry. 2008 Oct;49(10):1108-17. doi: 10.1111/j.1469-7610.2008.01939.x. Epub 2008 Jul 29.
There is uncertainty about the extent to which mildly sub-optimal perinatal characteristics among individuals born near-term (>33 weeks of gestation) are associated with various subsequent childhood problems, including antisocial behavior. There is even more uncertainty about whether the pathway to antisocial behavior differs by gender.
A sample of 1689 infants, born near-term, was followed from birth for over 30 years. Using structural equation modeling (SEM), the study evaluated hypothesized mechanisms linking perinatal problems to antisocial behavior, mediated through the following variables in early and later childhood: neurological abnormalities at age 1; hearing, speech, and language problems at age 3; cognitive function at age 4; and academic performance at age 7. Childhood problems were assessed by trained research clinicians, blind to perinatal status. An 'antisocial behavior' variable was created, based on retrospective self-report of six antisocial incidences assessed in adulthood.
Path coefficients showed that birthweight, head circumference, and Apgar scores were indirectly associated with antisocial behavior in the presence of one or more of the following: neurological abnormalities, abnormality in language, speech, and hearing, cognitive function, or academic performance. We found gender differences only in the associations between hearing and IQ and between language perception and IQ. Poor academic performance was associated with antisocial behavior in both boys and girls.
Our hypothesis, that perinatal problems may progress to antisocial behavior when mediated by various markers of early childhood problems, was confirmed. Adverse perinatal events need to be considered in identifying infants who are at risk for academic problems and antisocial behavior, even when the infant is born relatively close to term (i.e., >33 weeks). Poor academic performance, which is indirectly influenced by a variety of neurological and cognitive problems during the perinatal period, infancy, and early childhood appear to increase antisocial behavioral problems in both girls and boys.
对于孕周大于33周的近足月出生个体中，轻度次优围产期特征与包括反社会行为在内的各种后续儿童期问题的关联程度存在不确定性。关于反社会行为的途径是否因性别而异，不确定性更大。
对1689名近足月出生的婴儿进行了出生后30多年的随访。该研究使用结构方程模型（SEM），评估了围产期问题与反社会行为之间的假设机制，这些机制通过儿童早期和后期的以下变量介导：1岁时的神经异常；3岁时的听力、言语和语言问题；4岁时的认知功能；以及7岁时的学业成绩。儿童期问题由训练有素的研究临床医生进行评估，他们对围产期状况不知情。基于成年期评估的六项反社会事件的回顾性自我报告创建了一个“反社会行为”变量。
路径系数表明，在存在以下一种或多种情况时，出生体重、头围和阿氏评分与反社会行为间接相关：神经异常、语言、言语和听力异常、认知功能或学业成绩。我们仅在听力与智商以及语言感知与智商之间的关联中发现了性别差异。学业成绩不佳与男孩和女孩的反社会行为均相关。
我们的假设，即围产期问题在由儿童早期问题的各种标志物介导时可能发展为反社会行为，得到了证实。在识别有学业问题和反社会行为风险的婴儿时，需要考虑不良围产期事件，即使婴儿出生时相对接近足月（即孕周大于33周）。围产期、婴儿期和儿童早期受各种神经和认知问题间接影响的学业成绩不佳，似乎会增加男孩和女孩的反社会行为问题。
