Saigal S, Szatmari P, Rosenbaum P, Campbell D, King S
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
J Pediatr. 1991 May;118(5):751-60. doi: 10.1016/s0022-3476(05)80043-5.
The intellectual, psychoeducational, and functional status of a regional cohort of extremely low birth weight (ELBW) survivors who weighed 501 to 1000 gm at birth (n = 143) and who were born between 1977 and 1981 was compared with that of control children born at term (n = 145) who were matched for gender, age, and social class. One hundred twenty-nine ELBW survivors (90%) were available; their mean birth weight was 839 +/- 124 gm and mean gestational age 27 +/- 2.1 weeks, and 48 of them weighed less than or equal to 800 gm at birth. Both ELBW and control groups were tested at a mean unadjusted age of 8 years; 113 of 129 ELBW children completed the full test battery, eight blind children had other tests, and eight were not testable. The mean Full Scale IQ (Wechsler Intelligence Scale for Children--Revised) was 91 +/- 16 for ELBW children and 104 +/- 12 for control children (p less than 0.0001). Between 8% and 12% of the ELBW group scored in the "abnormal" range (less than or equal to -2 SD) on the Wechsler IQ and subtests, compared with 1% to 2% of the control group. The ELBW group did less well on the reading, spelling, and mathematics tests (Wide Range Achievement Test--Revised less than or equal to -2 SD: ELBW = 20% to 28%; control = 3% to 10%). The motor performance of the ELBW group (Bruininks-Oseretsky Test of Motor Proficiency less than or equal to -2 SD: ELBW = 20%; control = 1%) and their visual-motor integration (Beery Developmental Test of Visual-Motor Integration less than or equal to -2 SD: ELBW = 21%; control = 6%) were also poorer. Exclusion of 19 ELBW children with neurologic impairments or an IQ less than or equal to 70 or both did not result in significant improvement in Wechsler or achievement measures. Approximately 15% of the ELBW cohort performed in the abnormal range on the Vineland Adaptive Behavior Scales, compared with none of the control group. Although approximately two thirds of the ELBW group were performing in the normal range on intellectual measures, comparison with the control group suggests that, as a group, ELBW children were significantly disadvantaged on every measure tested.
对1977年至1981年期间出生体重在501至1000克之间的极低出生体重（ELBW）幸存者组成的区域队列（n = 143）的智力、心理教育和功能状况，与按性别、年龄和社会阶层匹配的足月出生的对照儿童（n = 145）进行了比较。129名ELBW幸存者（90%）参与了研究；他们的平均出生体重为839±124克，平均胎龄为27±2.1周，其中48名出生时体重小于或等于800克。ELBW组和对照组均在平均未校正年龄8岁时接受测试；129名ELBW儿童中有113名完成了全部测试，8名失明儿童进行了其他测试，8名无法进行测试。ELBW儿童的平均全量表智商（韦氏儿童智力量表修订版）为91±16，对照组儿童为104±12（p＜0.0001）。ELBW组中8%至12%的儿童在韦氏智商及子测试中得分处于“异常”范围（小于或等于-2标准差），而对照组为1%至2%。ELBW组在阅读、拼写和数学测试（广泛成就测试修订版小于或等于-2标准差：ELBW = 20%至28%；对照组 = 3%至10%）中的表现较差。ELBW组的运动能力（布鲁宁克斯-奥塞瑞斯基运动技能测试小于或等于-2标准差：ELBW = 20%；对照组 = 1%）及其视动整合能力（贝里视动整合发育测试小于或等于-2标准差：ELBW = 21%；对照组 = 6%）也较差。排除19名有神经功能障碍或智商小于或等于70或两者皆有的ELBW儿童，并未使韦氏测试或学业成绩测量结果有显著改善。ELBW队列中约15%的儿童在文兰适应行为量表上的表现处于异常范围，而对照组无一例如此。尽管ELBW组中约三分之二的儿童在智力测量中表现处于正常范围，但与对照组相比表明，作为一个群体，ELBW儿童在每项测试测量中都明显处于劣势。
