Department of Pediatrics, Turku University Hospital, Turku, Finland.
Acta Paediatr. 2010 Mar;99(3):359-66. doi: 10.1111/j.1651-2227.2009.01589.x. Epub 2009 Nov 12.
To study cognitive outcome of premature, very low birth weight (VLBW) infants in relation to parental education and neonatal data.
A regional cohort of 182 VLBW infants born between 2001 and 2006 was followed up. Brain ultrasounds (US) were examined serially until term age and brain magnetic resonance imaging at term age. Neurological status was examined systematically. Cognitive development was assessed using the Mental Developmental Index (MDI) of Bayley Scales at 2 years of corrected age. A total of 192 healthy full-term (FT) controls were assessed with the MDI at 2 years of age.
The mean MDI in VLBW infants was 101.7 (SD 15.4), which was lower compared with FT controls (109.8, SD 11.7, p < 0.001). In regression analysis of the demographic and medical data of VLBW infants, postnatal corticosteroids (p = 0.04), intestinal perforation (p = 0.03) and major brain pathology (p = 0.02) were negatively associated with the MDI. In VLBW infants, the prevalence of neurodevelopmental impairment was 9.9% (3.3% MDI below 70, 7.1% cerebral palsy, 2.2% hearing aid, no blind infants).
Cognitive development of VLBW infants seemed to have improved in comparison with earlier publications, but it differed from the FT controls. Neonatal factors affected cognitive development. Therefore, updated regional follow-up data are important for clinicians.
研究与父母教育和新生儿数据相关的早产儿极低出生体重儿（VLBW）的认知结果。
对 2001 年至 2006 年间出生的 182 例 VLBW 婴儿进行了一项区域性队列研究。对脑超声（US）进行了连续检查，直至足月年龄，并在足月年龄时进行了脑磁共振成像。系统地检查了神经状态。使用贝利发育量表的心理发育指数（MDI）在 2 岁时评估认知发育。共有 192 名健康的足月（FT）对照组在 2 岁时使用 MDI 进行评估。
VLBW 婴儿的平均 MDI 为 101.7（SD 15.4），与 FT 对照组（109.8，SD 11.7，p <0.001）相比较低。在 VLBW 婴儿的人口统计学和医学数据回归分析中，产后皮质类固醇（p = 0.04）、肠穿孔（p = 0.03）和主要脑病理学（p = 0.02）与 MDI 呈负相关。在 VLBW 婴儿中，神经发育障碍的患病率为 9.9%（3.3%的 MDI 低于 70，7.1%脑瘫，2.2%助听器，无盲婴儿）。
与早期出版物相比，VLBW 婴儿的认知发育似乎有所改善，但与 FT 对照组不同。新生儿因素影响认知发育。因此，更新的区域随访数据对临床医生很重要。
