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早期干预可改善早产儿的认知结局:随机对照试验。

Early intervention improves cognitive outcomes for preterm infants: randomized controlled trial.

机构信息

University Hospital of North Norway, Department of Pediatrics, Box 53, N-9012 Tromsø, Norway.

出版信息

Pediatrics. 2010 Nov;126(5):e1088-94. doi: 10.1542/peds.2010-0778. Epub 2010 Oct 11.

Abstract

OBJECTIVE

The goal was to examine the effectiveness of an early intervention on cognitive and motor outcomes at corrected ages of 3 and 5 years for children with birth weights (BWs) of <2000 g.

METHODS

A randomized controlled trial of a modified version of the Mother-Infant Transaction Program was performed. Outcomes were assessed with the Bayley Scales of Infant Development II and the Wechsler Preschool and Primary Scale of Intelligence-Revised at 3 and 5 years, respectively. McCarthy Scales of Children's Abilities and the grooved pegboard test were used to test motor outcomes at 5 years.

RESULTS

A total of 146 infants were assigned randomly (intervention group: 72 infants; control group: 74 infants). The mean BWs were 1396 ± 429 g for the intervention group and 1381 ± 436 g for the control group. After adjustment for maternal education, a nonsignificant difference in Mental Developmental Index scores at 3 years of 4.5 points (95% confidence interval: -0.3 to 9.3 points) in favor of the intervention group was found, whereas the intervention effect on full-scale IQ scores at 5 years was 6.4 points (95% confidence interval: 0.6-12.2 points). Significantly more children in the intervention group had IQ scores of ≥ 85 at 3 and 5 years. There were no differences between the groups with respect to motor outcomes.

CONCLUSION

This modified version of the Mother-Infant Transaction Program improved cognitive outcomes at corrected age of 5 years for children with BWs of <2000 g.

摘要

目的

研究对出生体重<2000 克的婴儿在矫正年龄 3 岁和 5 岁时进行早期干预对认知和运动结果的影响。

方法

进行了一项改良版母婴互动训练方案的随机对照试验。采用贝利婴幼儿发展量表第二版和韦氏学前和小学智力量表修订版分别在 3 岁和 5 岁时评估结果。在 5 岁时使用麦卡锡儿童能力量表和槽形钉板测试来评估运动结果。

结果

共有 146 名婴儿被随机分配(干预组:72 名婴儿;对照组:74 名婴儿)。干预组的平均出生体重为 1396±429 克,对照组为 1381±436 克。在调整了母亲的教育程度后,干预组在 3 岁时的精神发育指数评分有一个不显著的优势,差异为 4.5 分(95%置信区间:-0.3 至 9.3 分),而在 5 岁时的全面智商评分的干预效果为 6.4 分(95%置信区间:0.6 至 12.2 分)。干预组有更多的儿童在 3 岁和 5 岁时的智商得分≥85。两组在运动结果方面没有差异。

结论

这种改良版的母婴互动训练方案改善了出生体重<2000 克的婴儿在矫正年龄 5 岁时的认知结果。

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