National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-D02, Atlanta, GA, 30333. USA,
Matern Child Health J. 2011 Oct;15(7):836-44. doi: 10.1007/s10995-009-0538-2.
The primary goal of this study was to assess the association between the full birth weight distribution and prevalence of specific developmental disabilities and related measures of health and special education services utilization in US children. Using data from the 1997-2005 National Health Interview Survey (NHIS) Sample Child Core, we identified 87,578 children 3-17 years of age with parent-reported information on birth weight. We estimated the prevalences of DDs (attention-deficit/hyperactivity disorder [ADHD], autism, cerebral palsy, hearing impairment, learning disability without mental retardation, mental retardation, seizures, stuttering/stammering, and other developmental delay) and several indicators of health services utilization within a range of birth weight categories. We calculated odds ratios adjusted for demographic factors (AOR). We observed trends of decreasing disability/indicator prevalence with increasing birth weight up to a plateau. Although associations were strongest for very low birth weight, children with "normal" birth weights of 2,500-2,999 g were more likely than those with birth weights of 3,500-3,999 g to have mental retardation (AOR 1.9 [95% CI: 1.4-2.6]), cerebral palsy (AOR 2.4 [95% CI: 1.5-3.8]), learning disability without mental retardation (AOR 1.2 [95% CI: 1.1-1.4]), ADHD (AOR 1.2 [95% CI: 1.1-1.3]), and other developmental delay (AOR 1.3 [95% CI: 1.1-1.5]) and to receive special education services (AOR 1.3 [95% CI: 1.2-1.5]). While much research has focused on the health and developmental outcomes of low and very low birth weight children, these findings suggest that additional study of a continuous range of birth weights may be warranted.
这项研究的主要目的是评估美国儿童全出生体重分布与特定发育障碍及相关健康和特殊教育服务利用的流行率之间的关系。我们利用来自 1997-2005 年全国健康访谈调查(NHIS)样本儿童核心的数据,确定了 87578 名 3-17 岁父母报告出生体重信息的儿童。我们在一系列出生体重类别中估计了发育障碍(注意缺陷/多动障碍[ADHD]、自闭症、脑瘫、听力损伤、无智力障碍的学习障碍、智力障碍、癫痫发作、口吃/结巴和其他发育迟缓)和一些健康服务利用指标的流行率。我们调整了人口统计学因素(AOR)计算了比值比。我们观察到,随着出生体重的增加,残疾/指标的流行率呈下降趋势,直到达到一个平台。尽管极低出生体重的相关性最强,但出生体重为 2500-2999 克的“正常”体重儿童比出生体重为 3500-3999 克的儿童更有可能患有智力障碍(AOR1.9 [95%CI:1.4-2.6])、脑瘫(AOR2.4 [95%CI:1.5-3.8])、无智力障碍的学习障碍(AOR1.2 [95%CI:1.1-1.4])、ADHD(AOR1.2 [95%CI:1.1-1.3])和其他发育迟缓(AOR1.3 [95%CI:1.1-1.5]),并且更有可能接受特殊教育服务(AOR1.3 [95%CI:1.2-1.5])。虽然许多研究都集中在低出生体重和极低出生体重儿童的健康和发育结果上,但这些发现表明,可能需要对连续出生体重范围进行进一步研究。