Bora Samudragupta, Pritchard Verena E, Moor Stephanie, Austin Nicola C, Woodward Lianne J
Canterbury Child Development Research Group, University of Canterbury, Christchurch, New Zealand.
J Paediatr Child Health. 2011 Dec;47(12):863-9. doi: 10.1111/j.1440-1754.2011.02105.x. Epub 2011 Jun 17.
This paper describes the emotional and behavioural adjustment of children born very preterm (VPT) at early school age. Of particular interest was the degree of agreement between parents and teachers, and the extent of situational (parent or teacher) and pervasive (parent and teacher reported) adjustment problems.
A regionally representative cohort of 104 VPT (≤33 weeks gestation) and 108 full-term (FT) children born during 1998-2000 was studied prospectively to age six. At corrected age six, child emotional and behavioural adjustment was assessed using the parent and teacher rated strengths and difficulties questionnaires.
According to parents, 6-year-old VPT children had odds of emotional, inattention/hyperactivity and peer problems that were 2.7 to 3.8 times higher than their FT peers. Similar difficulties were identified by teachers, but odds were much lower and nonsignificant (1.1-1.8). Agreement between parents and teachers was lower in the VPT than the FT group (mean alternative chance-correlated coefficient , AC(1) = 0.63 vs. 0.80). Examination of the extent of pervasively identified adjustment problems showed that VPT children had higher rates of emotional (6% vs. 1%) and inattention/hyperactivity problems (12% vs. 6%) than FT children.
Early school age, VPT children are at increased risk of pervasive emotional problems and inattention/hyperactivity, although these risks are relatively modest. The use of multiple informants to assess VPT children's well-being is important to minimise the effects of report source bias and the over-identification of adjustment problems in children born VPT.
本文描述了极早产儿（VPT）在学龄早期的情绪和行为调适情况。特别令人感兴趣的是家长与教师之间的一致程度，以及情境性（家长或教师报告）和普遍性（家长和教师均报告）调适问题的程度。
对1998年至2000年期间出生的104名极早产儿（胎龄≤33周）和108名足月儿（FT）组成的具有区域代表性的队列进行前瞻性研究，直至儿童6岁。在矫正年龄6岁时，使用家长和教师评定的长处和困难问卷对儿童的情绪和行为调适进行评估。
根据家长报告，6岁的极早产儿出现情绪、注意力不集中/多动及同伴问题的几率比足月儿同伴高2.7至3.8倍。教师也发现了类似的困难，但几率要低得多且无统计学意义（1.1 - 1.8）。极早产儿组中家长与教师之间的一致性低于足月儿组（平均替代机会相关系数，AC(1)=0.63对0.80）。对普遍存在的调适问题程度的检查表明，极早产儿出现情绪问题（6%对1%）和注意力不集中/多动问题（12%对6%）的比例高于足月儿。
在学龄早期，极早产儿出现普遍性情绪问题和注意力不集中/多动的风险增加，尽管这些风险相对较小。使用多个信息提供者来评估极早产儿的幸福感对于尽量减少报告来源偏差的影响以及过度识别极早产儿的调适问题很重要。
