Mu Shu-Chi, Lin Cheng-Hui, Chen Yi-Ling, Chang Chia-Han, Tsou Kuo-Inn
Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Pediatr Neonatol. 2008 Apr;49(2):13-8. doi: 10.1016/S1875-9572(08)60005-4.
The majority of children born with very low birth weight (VLBW; < 1500g) enter mainstream schools. They experience significant neurodevelopmental disabilities during childhood. The specific aims of our study were to evaluate the neonatal outcomes of VLBW infants and whether they would influence intelligence quotient (IQ), cognitive function and learning disabilities at the age of 6 or 8 years.
We enrolled VLBW neonates who weighed less than 1500g and who were delivered at Shin-Kong Wu Ho-Su Memorial Hospital in 1996 and 1999. The psychological assessments were applied with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) for age 6 and Wechsler Intelligence Scale for Children-Third Edition (WISC-III) for age 8. We recorded their demographic data, ventilation duration by days, length of stay, use of surfactant, respiratory distress syndrome (RDS), and other complications.
According to whether the full scale intelligence quotient (FSIQ) was above or below the average score (FSIQ = 90), we divided VLBW children into two groups (< 90, n = 17; > or = 90, n = 21). The children with lower gestational age had lower FSIQ (p = 0.013). The higher FSIQ group (> or = 90) showed more prenatal steroid use (5/17, 29.4% vs. 14/21, 66.7%; p = 0.049). There were more boys in the lower FSIQ group (< 90, 13/17, 76.5% vs. > or = 90, 7/21, 33.3%; p = 0.011). The average IQ scores were 78.11 +/- 9.05 and 102.57 +/- 8.89 in the FSIQ < 90 and FSIQ > or = 90 groups, respectively. The groups were similar in ventilation duration by days, use of surfactant, frequency of sepsis, RDS, bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular hemorrhage and retinopathy of prematurity.
In our study, the children with lower gestational age had lower FSIQ. There was no significant association between small for gestational age and IQ performance. The neonatal outcomes of VLBW infants did have less impact on IQ performance later in life.
大多数极低出生体重（VLBW；<1500g）儿进入了主流学校。他们在儿童期经历了显著的神经发育障碍。我们研究的具体目的是评估极低出生体重儿的新生儿结局，以及这些结局是否会影响其6岁或8岁时的智商（IQ）、认知功能和学习障碍。
我们纳入了1996年和1999年在新光吴火狮纪念医院出生的体重小于1500g的极低出生体重儿。6岁时采用韦氏学前及初小儿童智力量表（WPPSI），8岁时采用韦氏儿童智力量表第三版（WISC-III）进行心理评估。我们记录了他们的人口统计学数据、通气天数、住院时间、表面活性剂的使用情况、呼吸窘迫综合征（RDS）及其他并发症。
根据全量表智商（FSIQ）高于或低于平均分（FSIQ = 90），我们将极低出生体重儿分为两组（<90，n = 17；≥90，n = 21）。孕周较小的儿童FSIQ较低（p = 0.013）。FSIQ较高的组（≥90）产前使用类固醇的情况更多（5/17，29.4% 对14/21，66.7%；p = 0.049）。FSIQ较低的组（<90）男孩更多（13/17，76.5% 对≥90，7/21，33.3%；p = 0.011）。FSIQ<90组和FSIQ≥90组的平均智商得分分别为78.11±9.05和102.57±8.89。两组在通气天数、表面活性剂的使用、败血症发生率、RDS、支气管肺发育不良、动脉导管未闭、脑室内出血和早产儿视网膜病变方面相似。
在我们的研究中，孕周较小的儿童FSIQ较低。小于胎龄与智商表现之间无显著关联。极低出生体重儿的新生儿结局对其后期生活中的智商表现影响较小。
