Department of Pediatrics, Turku University Hospital, Kiinamyllynkatu 4-8, Turku, Finland.
Eur Child Adolesc Psychiatry. 2010 Aug;19(8):669-77. doi: 10.1007/s00787-010-0104-x. Epub 2010 Mar 23.
The place and time of birth influence the mortality of premature infants. We studied the effect of prematurity, time of birth, birth hospital level and district on the development and behaviour in a national cohort of 5-year-old Finnish very low birthweight infants (VLBWI). All surviving VLBWI (gestational age <32 weeks or birthweight <or=1,500 g) born in 2001-2002 in level II or III hospitals in Finland and full-term controls were included. The parents of 588 (64%) VLBWI and 176 (46%) controls returned the Five to Fifteen questionnaire (FTF) on the development and behaviour of their 5-year-old children. The questionnaire scores were linked to data from the National Medical Birth Register, the Hospital Discharge Register, the Register of Congenital Malformations and the Cause of Death Register. VLBWI had lower developmental and behavioural scores compared to the controls in all FTF domains. In VLBWI, the scores were less optimal, the lower the gestational age was. The time of birth, birth hospital level and district were not associated with the developmental and behavioural scores in VLBWI. In conclusion, short duration of pregnancy adversely influences development and behaviour in VLBWI. Despite differences previously demonstrated in mortality related to time and place of birth, there were no differences in developmental and behavioural scores in VLBWI according to the time of birth, birth hospital level or district. Thus, the survival advantage in level III hospitals seems not to be gained at the expense of behavioural or developmental problems.
出生地点和时间会影响早产儿的死亡率。我们研究了早产、出生时间、分娩医院水平和地区对芬兰一项全国范围内 5 岁极低出生体重儿（VLBWI）队列的发育和行为的影响。所有在 2001-2002 年在芬兰二级或三级医院出生的存活 VLBWI（胎龄<32 周或出生体重<或=1500 克）和足月对照均被纳入研究。588 名（64%）VLBWI 和 176 名（46%）对照的父母返回了 Five to Fifteen 问卷（FTF），以评估他们 5 岁孩子的发育和行为。问卷得分与国家医疗出生登记处、住院病人登记处、先天性畸形登记处和死因登记处的数据相关联。与对照组相比，VLBWI 在所有 FTF 领域的发育和行为评分均较低。VLBWI 的胎龄越低，评分越不理想。出生时间、分娩医院水平和地区与 VLBWI 的发育和行为评分无关。总之，妊娠时间较短会对 VLBWI 的发育和行为产生不利影响。尽管此前已经证明了与出生时间和地点相关的死亡率存在差异，但根据出生时间、分娩医院水平或地区，VLBWI 的发育和行为评分没有差异。因此，三级医院的生存优势似乎并没有以行为或发育问题为代价获得。
