Department of Health Sciences, University of Leicester, Leicester LE1 6TP, United Kingdom.
Pediatr Res. 2011 May;69(5 Pt 2):11R-8R. doi: 10.1203/PDR.0b013e318212faa0.
Epidemiologic studies have, for many years, identified preterm birth as a significant risk factor for psychiatric disorders. There has been a recent resurgence of interest in neurobehavioral outcomes after preterm birth. In this article, we review clinical cohort studies of the prevalence, etiology, and risk factors for psychiatric sequelae in ex-preterm children. Studies using diagnostic psychiatric evaluations are few in number but typically report a 3- to 4-fold increased risk for disorders in middle childhood. Our review of studies reveals a "preterm behavioral phenotype" characterized by an increased risk for symptoms and disorders associated with inattention, anxiety, and social difficulties. The most contemporary studies have also reported a markedly increased prevalence of autism spectrum disorders (ASD) in preterm populations. Our examination of the correlates and comorbidities of psychiatric disorders is indicative of a different causative pathway that may be associated with altered brain development after preterm birth. Despite the low population attributable risk, the frequency of these symptoms and disorders means that psychiatric screening is likely to be beneficial in this vulnerable population.
多年来，流行病学研究已经将早产确定为精神障碍的一个重要危险因素。最近，人们对早产儿的神经行为后果重新产生了兴趣。在本文中，我们回顾了早产儿童精神后遗症的患病率、病因和危险因素的临床队列研究。使用诊断性精神评估的研究数量很少，但通常报告说，在儿童中期，疾病的风险增加了 3 到 4 倍。我们对研究的回顾揭示了一种“早产行为表型”，其特征是与注意力不集中、焦虑和社交困难相关的症状和障碍的风险增加。最新的研究还报告说，早产儿群体中自闭症谱系障碍（ASD）的患病率明显增加。我们对精神障碍的相关性和合并症的研究表明，可能存在与早产后脑发育改变相关的不同致病途径。尽管人群归因风险低，但这些症状和障碍的频率意味着在这个脆弱的人群中进行精神筛查可能是有益的。
