Department of Pediatrics, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
BMC Pediatr. 2010 Mar 5;10:12. doi: 10.1186/1471-2431-10-12.
Various perinatal factors influencing neuromotor development are known from cross sectional studies. Factors influencing the age at which distinct abilities are acquired are uncertain. We hypothesized that the Cox regression model might identify these factors.
Neonates treated at Aachen University Hospital in 2000/2001 were identified retrospectively (n = 796). Outcome data, based on a structured interview, were available from 466 children, as were perinatal data. Factors possibly related to outcome were identified by bootstrap selection and then included into a multivariate Cox regression model. To evaluate if the parental assessment might change with the time elapsed since birth we studied five age cohorts of 163 normally developed children.
Birth weight, gestational age, congenital cardiac disease and periventricular leukomalacia were related to outcome in the multivariate analysis (p < 0.05). Analysis of the control cohorts revealed that the parents' assessment of the ability of bladder control is modified by the time elapsed since birth.
Combined application of the bootstrap resampling procedure and multivariate Cox regression analysis effectively identifies perinatal factors influencing the age at which distinct abilities are acquired. These were similar as known from previous cross sectional studies. Retrospective data acquisition may lead to a bias because the parental memories change with time. This recommends applying this statistical approach in larger prospective trials.
从横断面研究中可知，有许多围产期因素会影响神经运动发育。影响特定能力获得年龄的因素尚不确定。我们假设 Cox 回归模型可以识别这些因素。
回顾性地确定了 2000/2001 年在亚琛大学医院接受治疗的新生儿（n=796）。基于结构化访谈获得了 466 名儿童的结局数据和围产期数据。通过自举选择确定了可能与结局相关的因素，然后将这些因素纳入多变量 Cox 回归模型。为了评估父母的评估是否会随着出生后时间的推移而改变，我们研究了 5 个年龄组的 163 名正常发育的儿童。
多变量分析显示，出生体重、胎龄、先天性心脏病和脑室周围白质软化与结局相关（p<0.05）。对对照组的分析表明，父母对膀胱控制能力的评估随着出生后时间的推移而发生变化。
Bootstrap 重采样程序和多变量 Cox 回归分析的联合应用有效地确定了影响特定能力获得年龄的围产期因素。这些因素与之前的横断面研究结果相似。回顾性数据采集可能会导致偏差，因为父母的记忆会随时间而变化。因此，建议在更大的前瞻性试验中应用这种统计方法。
