Kalia Jessica L, Visintainer Paul, Brumberg Heather L, Pici Maria, Kase Jordan
New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, Department of Pediatrics, Division of Newborn Medicine, 95 Grasslands Rd, Valhalla, NY 10595, USA.
Pediatrics. 2009 Mar;123(3):804-9. doi: 10.1542/peds.2008-0928.
To determine the requirement for therapeutic services of late-preterm infants (34 to 36 weeks' gestation) and morbidities associated with their developmental delays compared with their very preterm (<32 weeks' gestation) counterparts.
We used a retrospective cohort study of former preterm children admitted to the neonatal unit who were evaluated at the Regional Neonatal Follow-up Program of Westchester Medical Center in New York at 12 +/- 2 months' corrected age from January 2005 through October 2006. Logistic regression was used to compare odds ratios between late-preterm and very preterm children who qualified for early intervention services. Antenatal, demographic, and neonatal factors were compared between subgroups.
Of the 497 preterm infants evaluated at the Regional Neonatal Follow-up Program, 127 met inclusion criteria (77 very preterm and 50 late-preterm infants). Of the late-preterm infants, 30% qualified for and received early intervention services, 28% physical therapy, 16% occupational therapy, 10% speech therapy, and 6% special education. In the very preterm subgroup, 70% qualified for and received early intervention services, 66% physical therapy, 32% occupational therapy, 32% speech therapy, and 21% special education. Very preterm children were more likely to be enrolled in therapies than their late-preterm counterparts. However, when adjusting for neonatal comorbidities of prematurity, there was no difference in enrollment in early intervention services between the very preterm and late-preterm infants.
After controlling for comorbidities of prematurity, we found that late-preterm infants requiring admission to the neonatal unit have the same risk as very preterm infants of requiring interventional therapies. This would indicate that it is not only the degree of prematurity but also the morbidities experienced in the neonatal period in conjunction with the period of rapid brain growth that have a profound influence on neurodevelopmental outcomes. This should be considered when planning their hospital discharge and follow-up.
确定晚期早产儿（妊娠34至36周）对治疗服务的需求，以及与极早产儿（妊娠<32周）相比，其发育迟缓相关的发病率。
我们对入住新生儿科的 former preterm children 进行了一项回顾性队列研究，这些儿童于2005年1月至2006年10月在纽约韦斯特切斯特医疗中心的区域新生儿随访项目中，在矫正年龄12±2个月时接受评估。使用逻辑回归比较符合早期干预服务条件的晚期早产儿和极早产儿之间的比值比。在亚组之间比较产前、人口统计学和新生儿因素。
在区域新生儿随访项目评估的497名早产儿中，127名符合纳入标准（77名极早产儿和50名晚期早产儿）。在晚期早产儿中，30%符合并接受了早期干预服务，28%接受物理治疗，16%接受职业治疗，10%接受言语治疗，6%接受特殊教育。在极早产儿亚组中，70%符合并接受了早期干预服务，66%接受物理治疗，32%接受职业治疗，32%接受言语治疗，21%接受特殊教育。极早产儿比晚期早产儿更有可能接受治疗。然而，在调整早产的新生儿合并症后，极早产儿和晚期早产儿在早期干预服务的登记方面没有差异。
在控制早产合并症后，我们发现需要入住新生儿科的晚期早产儿与极早产儿需要介入治疗的风险相同。这表明不仅早产程度，而且新生儿期经历的合并症以及脑快速生长时期对神经发育结局都有深远影响。在规划他们的出院和随访时应考虑到这一点。
