Department of Women and Children Health, Sachs Children's Hospital, Karolinska Institutet, Stockholm, Sweden.
Pediatrics. 2010 Jan;125(1):e67-73. doi: 10.1542/peds.2008-3329. Epub 2009 Dec 7.
The aim was to study the impact of a range of gestational ages (GAs) on cognitive competence in late adolescence and how this effect is modified by contextual social adversity in childhood.
This was a register study based on a national cohort of 119664 men born in Sweden from 1973 to 1976. Data on GA and other perinatal factors were obtained from the Medical Birth Register, and information on cognitive test scores was extracted from military conscription at the ages of 18 to 19 years. Test scores were analyzed as z scores on a 9-point stanine scale, whereby each unit is equivalent to 0.5 SD. Socioeconomic indicators of the childhood household were obtained from the Population and Housing Census of 1990. The data were analyzed by multivariate linear regression.
The mean cognitive test scores decreased in a stepwise manner with GA. In unadjusted analysis, the test scores were 0.63 stanine unit lower in men who were born after 24 to 32 gestational weeks than in those who were born at term. The difference in global scores between the lowest and highest category of socioeconomic status was 1.57. Adjusting the analysis for the childhood socioeconomic indicators decreased the effect of GA on cognitive test scores by 26% to 33%. There was also a multiplicative interaction effect of social adversity and moderately preterm birth on cognitive test scores.
This study confirms previous claims of an incremental association of cognitive competence with GA. Socioeconomic indicators in childhood modified this effect at all levels of preterm birth.
研究一系列孕龄（GA）对青春期后期认知能力的影响，以及这种影响如何受到儿童时期背景社会逆境的影响。
这是一项基于瑞典 1973 年至 1976 年出生的 119664 名男性的全国队列的登记研究。GA 和其他围产期因素的数据来自于医疗出生登记处，认知测试分数的信息来自于 18 至 19 岁的兵役征兵。测试分数作为 9 点斯坦纳量表上的 z 分数进行分析，每个单位相当于 0.5 个标准差。童年家庭的社会经济指标来自于 1990 年的人口和住房普查。通过多元线性回归对数据进行分析。
认知测试分数随 GA 呈逐步下降趋势。在未调整的分析中，与足月出生的男性相比，出生在 24 至 32 孕周之间的男性测试分数低 0.63 个斯坦纳单位。社会经济地位最低和最高类别之间的全球评分差异为 1.57。在分析中调整儿童社会经济指标，将 GA 对认知测试分数的影响降低了 26%至 33%。社会逆境和中度早产对认知测试分数也存在乘法交互作用。
本研究证实了先前关于认知能力与 GA 呈递增关联的说法。儿童时期的社会经济指标在早产的所有水平上都改变了这种影响。
