Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica.
Dev Med Child Neurol. 2010 Jul;52(7):e148-54. doi: 10.1111/j.1469-8749.2010.03637.x. Epub 2010 Feb 24.
The aim of this study was to determine whether psychosocial stimulation up to the age of 2 years benefits cognition and behaviour at age 6 years in low-birthweight, term-born (LBW-T) children (gestational age > or =37 wk, birthweight <2500g), and to compare LBW-T and normal-birthweight (NBW) children.
LBW-T Jamaican infants were randomized at birth to a control group or an intervention group. Children in the intervention group received psychosocial stimulation for 2 years. LBW-T infants were also compared with NBW infants born in the same hospital. IQ, cognitive function, and behaviour were measured at age 6 years in 109 LBW-T infants. The LBW-T group were divided into the intervention group (55 out of 70 enrolled, 32 females, 23 males; mean birthweight 2190g, SD 200g; and the control group (54 out of 70 enrolled, 33 females, 21 males; birthweight 2240g, SD 180g]. These were compared with 73 out of 94 enrolled NBW infants (38 females 35 males; birthweight 3130g, SD 330g).
Among the LBW-T children performance IQ scores were higher in the intervention group than in the control group (regression coefficient [B] 4.06, 95% confidence interval [CI] 0.01-7.98) as were visual-spatial memory scores (B 1.12, 95% CI 0.45-1.87). Children in the intervention group also exhibited fewer behavioural difficulties (B -2.21, 95% CI -4.13 to -0.10) than children in the control group. Compared with NBW children, LBW-T children in the control group had poorer selective attention (B=-3.35, 95% CI -5.59 to -1.26) and visual-spatial memory (B=-0.76, 95% CI -1.54 to 0.00), but there were no differences in IQ, language, or behaviour.
Stimulation had sustained benefits in LBW-T infants. Finding few differences between LBW-T and NBW school-aged children concurs with results from other developing countries.
本研究旨在探讨 2 岁前的心理社会刺激是否有益于低出生体重、足月（LBW-T）儿童（胎龄≥37 周，出生体重<2500g）6 岁时的认知和行为，并比较 LBW-T 与正常出生体重（NBW）儿童的差异。
出生时，LBW-T 牙买加婴儿被随机分为对照组或干预组。干预组的婴儿接受了 2 年的心理社会刺激。LBW-T 婴儿还与同一家医院出生的 NBW 婴儿进行了比较。109 名 LBW-T 婴儿在 6 岁时接受了智商、认知功能和行为的测量。LBW-T 组分为干预组（70 名入组儿童中的 55 名，女性 32 名，男性 23 名；平均出生体重 2190g，标准差 200g）和对照组（70 名入组儿童中的 54 名，女性 33 名，男性 21 名；出生体重 2240g，标准差 180g）。这些儿童与 73 名入组的 NBW 婴儿（女性 38 名，男性 35 名；出生体重 3130g，标准差 330g）进行了比较。
在 LBW-T 儿童中，干预组的表现智商评分高于对照组（回归系数 [B]4.06，95%置信区间 [CI]0.01-7.98），视觉空间记忆评分也较高（B1.12，95%CI0.45-1.87）。干预组的儿童表现出较少的行为问题（B-2.21，95%CI-4.13 至-0.10）。与 NBW 儿童相比，对照组的 LBW-T 儿童的选择性注意力较差（B=-3.35，95%CI-5.59 至-1.26）和视觉空间记忆较差（B=-0.76，95%CI-1.54 至 0.00），但智商、语言和行为没有差异。
刺激对 LBW-T 婴儿有持续的益处。在 LBW-T 和 NBW 学龄儿童之间发现的差异很少，这与其他发展中国家的结果一致。
