Department of Neuroscience, Norwegian University of Science and Technology, NO-7489 Trondheim, Norway.
J Dev Behav Pediatr. 2010 May;31(4):286-94. doi: 10.1097/DBP.0b013e3181d7b1d3.
To study perinatal risk factors for psychiatric symptoms in adolescents born preterm with very low birth weight or at term, but small for gestational age (GA).
Mental health was assessed in 65 adolescents born with very low birth weight (VLBW) (birth weight < or = 1500 g), 59 born term small for GA (birth weight <10th centile) and 81 control adolescents using Schedule for Affective Disorders and Schizophrenia for School-Age Children, Children's Global Assessment Scale, Autism Spectrum Screening Questionnaire, Attention-Deficit Hyperactivity Disorder-Rating Scale IV and Achenbach System of Empirically Based Assessment. Perinatal data included birth weight, GA, head circumference, Apgar scores, intraventricular hemorrhage, days in neonatal intensive care unit, and days on mechanical ventilation.
In the very low birth weight group, lower birth weight was associated with inattention (p < .01), psychiatric diagnoses, and reduced psychosocial function (p < or = .05). Intraventricular hemorrhage increased the risk for a high inattention score (odds ratio = 7.5; 95% confidence intervals: 1.2-46.8). Lower Apgar score at 1 min was associated with a high Autism Spectrum Screening Questionnaire score and lower Apgar score at 5 min with a high internalizing score (p < or = .05). In the subgroup born appropriate for GA, internalizing symptoms were also associated with lower GA. In the term small for GA group, perinatal events were not associated with psychiatric problems. In contrast, low socioeconomic status was associated with externalizing symptoms.
Lower birth weight, shorter gestation, and intraventricular hemorrhage were risk factors for psychiatric problems in the very low birth weight group. Lower Apgar score increased the risk for autism spectrum symptoms and internalizing symptoms. Among adolescents born term small for GA, the main risk factor for psychiatric symptoms was low socioeconomic status.
研究极低出生体重（出生体重≤1500 克）或足月但小于胎龄儿（出生体重<第 10 百分位）的青少年围产期精神症状的危险因素。
使用儿童青少年情感障碍和精神分裂症时间表、儿童总体评估量表、自闭症谱系筛查问卷、注意力缺陷多动障碍评定量表 IV 和基于经验的评估系统对 65 名极低出生体重儿（VLBW）、59 名足月小于胎龄儿和 81 名对照青少年进行心理健康评估。围产期数据包括出生体重、胎龄、头围、阿普加评分、颅内出血、新生儿重症监护病房天数和机械通气天数。
在极低出生体重组中，较低的出生体重与注意力不集中（p<0.01）、精神科诊断和社会心理功能降低有关（p<0.05）。脑室出血增加了高注意力得分的风险（比值比=7.5；95%置信区间：1.2-46.8）。1 分钟时较低的阿普加评分与较高的自闭症谱系筛查问卷评分相关，5 分钟时较低的阿普加评分与较高的内化评分相关（p<0.05）。在出生时胎龄适当的亚组中，内化症状也与较低的胎龄有关。在足月小于胎龄组中，围产期事件与精神问题无关。相比之下，社会经济地位较低与外化症状有关。
较低的出生体重、较短的胎龄和脑室出血是极低出生体重儿精神问题的危险因素。较低的阿普加评分增加了自闭症谱系症状和内化症状的风险。在足月小于胎龄儿中，精神症状的主要危险因素是社会经济地位较低。
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