Department of Psychiatry Research, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA.
Pediatrics. 2010 Jan;125(1):e83-9. doi: 10.1542/peds.2009-0634. Epub 2009 Dec 14.
By using behavioral outcome measures of children who were born preterm, we evaluated differences between children who were born at term and children who were born at extremely low (ELBW; <1000 g) and very low birth weights (VLBW; 1000-1499 g) and assessed the relationship of birth weight, socioeconomic status, and cognitive ability to behavioral outcome.
We studied a total of 104 children (aged 7-16 years). Of these, 49 had a preterm birth (31 of ELBW and 18 of VLBW). The remaining 55 were healthy control subjects. Children were administered tests of cognitive ability. Parents and teachers completed behavioral assessments. Multivariate analyses of covariance assessed differences between children who were born at term and those who were born of ELBW and of VLBW on behavioral measures. Hierarchical linear regressions were used to assess relationships among biological (birth weight), environmental (socioeconomic status), intellectual, and behavioral variables.
Children who were born at term had fewer parent reports of hyperactivity/inattention and depression/anxiety symptoms than children of ELBW and VLBW. Teacher ratings were not significant between groups. Birth weight was consistently the strongest predictor of parent ratings of behavioral outcome, and intelligence level did not seem to mediate this relationship.
Negative behavioral sequelae of preterm birth remain significant in middle childhood and adolescence, although the contribution of multiple factors to neurobehavioral outcome is complex. Research to assess these relationships, integrated with anatomic and functional neuroimaging, is needed to advance knowledge and improve outcomes for children who are born preterm.
通过对早产儿儿童的行为结果测量，我们评估了足月产儿与极低体重儿（ELBW；<1000 克）和超低体重儿（VLBW；1000-1499 克）之间的差异，并评估了出生体重、社会经济地位和认知能力与行为结果之间的关系。
我们共研究了 104 名儿童（年龄 7-16 岁）。其中，49 名早产儿（31 名 ELBW，18 名 VLBW）。其余 55 名是健康对照组。儿童接受认知能力测试。家长和教师完成行为评估。协方差的多变量分析评估了足月产儿与 ELBW 和 VLBW 产儿在行为测量方面的差异。分层线性回归用于评估生物学（出生体重）、环境（社会经济地位）、智力和行为变量之间的关系。
与 ELBW 和 VLBW 儿童相比，足月产儿童的家长报告多动/注意力不集中和抑郁/焦虑症状较少。教师评价在各组之间没有显著差异。出生体重是家长对行为结果评价的最强预测因素，而智力水平似乎并没有调节这种关系。
尽管多种因素对神经行为结果的影响很复杂，但早产儿的负面行为后果在儿童中期和青春期仍然显著。需要进行研究以评估这些关系，并与解剖和功能神经影像学相结合，以提高对早产儿的认识并改善其结果。
