Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
J Dev Behav Pediatr. 2011 Nov;32(9):678-87. doi: 10.1097/DBP.0b013e31822a396a.
: To systematically review and synthesize the literature to document the association between infants born very preterm and/or very low birth weight (VLBW) and the presence of developmental coordination disorder (DCD) at school age.
: Seven databases were systematically searched. Studies were included if they examined very preterm (<32 weeks) and/or VLBW (<1500 g) infants to school age (age, 5-18 years), had a full-term and/or normal birth weight comparison group, and used a formal measure of motor impairment. Studies that included only infants who were small for gestational age or diagnosed with cerebral palsy were excluded. Two independent reviewers completed abstract and full-text screening, data extraction, and quality assessment of included studies.
: Sixteen articles were included, with 7 studies incorporated into 2 meta-analyses using cutoff scores of either <5th or 5-15th percentile on the Movement Assessment Battery for Children. Both analyses showed a significant increase in the likelihood of DCD for children born very preterm and/or 1500 g or less, with odds ratios of 6.29 (95% confidence interval, 4.37-9.05, p < .00001) and 8.66 (95% confidence interval, 3.40-22.07, p < .00001) for <5th or 5-15th percentile scores, respectively.
: Consistent across studies, DCD is more prevalent in the VLBW/very preterm population than full-term/normal birth weight control children and the general school-age population, with significantly greater odds of developing the disorder. Clinical practice should focus on early identification of and intervention for children with DCD, while research should focus on determining the mechanisms underlying DCD in the preterm population.
系统回顾和综合文献,记录极低出生体重(VLBW)和极早产儿(<32 周)婴儿在学龄期出现发育性协调障碍(DCD)的相关性。
系统检索了 7 个数据库。如果研究检查了极早产儿(<32 周)和/或 VLBW(<1500g)婴儿到学龄期(年龄 5-18 岁),有一个足月和/或正常出生体重对照组,并且使用了正式的运动障碍测量方法,则将其纳入研究。仅包括因宫内生长受限或诊断为脑瘫而体重较小的婴儿的研究被排除在外。两名独立的审查员完成了摘要和全文筛选、数据提取以及纳入研究的质量评估。
共纳入 16 篇文章,其中 7 项研究纳入了两项使用儿童运动评估电池(Movement Assessment Battery for Children)<5 百分位或 5-15 百分位截断值的荟萃分析。这两项分析均表明,极早产儿和/或出生体重<1500g 的儿童发生 DCD 的可能性显著增加,其优势比分别为 6.29(95%置信区间 4.37-9.05,p<0.00001)和 8.66(95%置信区间 3.40-22.07,p<0.00001)。
一致的研究表明,DCD 在 VLBW/极早产儿人群中比足月/正常出生体重对照组和一般学龄期人群更为普遍,并且发病的几率显著更高。临床实践应重点关注 DCD 儿童的早期识别和干预,而研究应重点确定 DCD 在早产儿人群中的发病机制。