Department of Pediatrics, Sainte-Justine University Health Center, Montreal, Quebec, Canada.
Pediatrics. 2011 Aug;128(2):313-22. doi: 10.1542/peds.2010-2655. Epub 2011 Jul 18.
Very preterm adolescents display persistent deficits in neuropsychological functions.
To compare cognitive and language outcomes at 16 years and cognitive and receptive vocabulary trajectories throughout school years between very preterm and term children and to determine child and family factors associated with better developmental trajectories.
At 8, 12, and 16 years, 322 very preterm children with birth weights of 1250 g or less and 41 term children had cognitive and language testing. Hierarchical growth-curve modeling was used to delineate the differences in cognitive and receptive vocabulary development between participants. Cluster analyses allowed for the characterization of very preterm children with different patterns of cognitive and receptive vocabulary development.
At 16 years, very preterm adolescents had deficits in general cognition and higher-order language skills (phonological awareness and phonemic decoding) compared with term peers. Although the between-group difference in cognitive scores remained stable from 8 to 16 years, very preterm children demonstrated catch-up gains in receptive vocabulary during the same period. Moreover, subgroups of very preterm children displayed developmental trajectories in cognition similar to term children (55% on the vocabulary and 46% on the block-design subtests). These children had lower rates of neurosensory impairment and mothers with higher education and were from an ethnic nonminority.
Significant catch-up in receptive vocabulary is observed by the age of 16 years among very preterm children compared to term peers. The absence of neurosensory impairment and residing in a favorable socioeconomic milieu are associated with the most optimal developmental trajectories.
极早产儿在神经心理学功能方面持续存在缺陷。
比较极早产儿和足月儿童在 16 岁时的认知和语言结果以及整个学年的认知和接受性词汇轨迹，并确定与更好的发展轨迹相关的儿童和家庭因素。
在 8 岁、12 岁和 16 岁时，322 名出生体重为 1250 克或以下的极早产儿和 41 名足月儿童进行了认知和语言测试。分层增长曲线模型用于描绘参与者之间认知和接受性词汇发展的差异。聚类分析允许对具有不同认知和接受性词汇发展模式的极早产儿进行特征描述。
在 16 岁时，极早产儿在一般认知和高级语言技能（语音意识和音位解码）方面与足月同龄人存在缺陷。尽管从 8 岁到 16 岁，组间认知评分的差异保持稳定，但极早产儿在同一时期接受性词汇方面表现出追赶性增长。此外，极早产儿的亚组表现出与足月儿童相似的认知发展轨迹（词汇组的 55%和积木设计子测验的 46%）。这些儿童的神经感觉损伤率较低，母亲的教育程度较高，并且来自非少数民族。
与足月同龄人相比，极早产儿在 16 岁时接受性词汇量明显增加。没有神经感觉损伤和生活在有利的社会经济环境中与最佳的发展轨迹相关。
