Pritchard Verena E, Clark Caron A C, Liberty Kathleen, Champion Patricia R, Wilson Kimberley, Woodward Lianne J
Canterbury Child Development Research Group, Department of Psychology, University of Canterbury, New Zealand.
Early Hum Dev. 2009 Apr;85(4):215-24. doi: 10.1016/j.earlhumdev.2008.10.004. Epub 2008 Nov 20.
Educational underachievement is a major morbidity associated with very preterm (VPT) birth. However, few studies have examined early school outcomes with most employing global, clinic based measures.
To examine the early school achievement in a cohort of children born VPT and studied to age 6 years.
A regional cohort of 102 VPT children (</=33 weeks GA) were followed prospectively alongside a comparison group of 108 full term (FT) children born during the same period (1998-2000). At 6 years corrected age, all children underwent a comprehensive neurodevelopmental evaluation that included the Woodcock-Johnson Tests of Achievement (WJ-III), teacher report and national numeracy and literacy test results. Rates of specific learning disabilities (LD) were also examined.
VPT children performed less well than FT children on WJ-III subtests (ps<.05), national tests (ps<.01), and in all curricular areas rated by teachers (ps<.01) except expressive language. Even VPT children without severe neurodevelopmental impairment scored lower on the WJ-III math, national tests (ps<.05) and were 2-3 times more likely to show delays (ps<.02) in math (43% vs. 19%), written language (36% vs. 22%), language comprehension (26% vs. 14%), handwriting (36% vs. 17%), spelling (38% vs. 30%) and physical education (33% vs. 11%). They were also twice as likely as FT children to have math LD (47% vs. 21%).
By age 6, a substantial proportion of VPT children are lagging behind their FT peers across multiple curriculum areas, with difficulties being most prominent in math. Findings highlight the need for early identification and educational supports to help maximise VPT children's learning opportunities during the transition to school.
学业成绩不佳是与极早产（VPT）出生相关的主要发病问题。然而，很少有研究考察早期学校学习成果，大多数研究采用基于诊所的整体测量方法。
考察一组极早产出生且随访至6岁儿童的早期学业成绩。
对102名极早产儿童（孕周≤33周）组成的区域队列进行前瞻性随访，同时设立一个由108名同期（1998 - 2000年）出生的足月儿（FT）组成的对照组。在矫正年龄6岁时，所有儿童都接受了全面的神经发育评估，包括伍德科克 - 约翰逊成就测验（WJ - III）、教师报告以及全国性的算术和读写能力测试结果。还对特定学习障碍（LD）的发生率进行了检查。
在WJ - III子测验（p值<0.05）、全国性测试（p值<0.01）以及教师评定的所有课程领域（除表达性语言外，p值<0.01）中，极早产儿童的表现均不如足月儿。即使是没有严重神经发育障碍的极早产儿童，在WJ - III数学、全国性测试（p值<0.05）中得分也较低，并且在数学（43%对19%）、书面语言（36%对22%）、语言理解（26%对14%）、书写（36%对17%）、拼写（38%对30%）和体育（33%对11%）方面出现延迟的可能性是足月儿的2至3倍。他们患数学学习障碍的可能性也是足月儿的两倍（47%对21%）。
到6岁时，相当一部分极早产儿童在多个课程领域落后于足月儿同龄人，数学方面的困难最为突出。研究结果凸显了早期识别和教育支持的必要性，以帮助极早产儿童在过渡到学校期间最大限度地增加学习机会。
