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极低出生体重的年轻成年人的神经认知能力。

Neurocognitive abilities in young adults with very low birth weight.

机构信息

Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.

出版信息

Neurology. 2011 Dec 6;77(23):2052-60. doi: 10.1212/WNL.0b013e31823b473e.

Abstract

OBJECTIVE

Although severely preterm birth has been associated with impaired neurocognitive abilities in children, follow-up studies in adulthood are scarce. We set out to study whether adults born with very low birth weight (VLBW) (<1,500 g), either small for gestational age (SGA) (birth weight ≤-2 SD) or appropriate for gestational age (AGA), differ in a range of neurocognitive abilities and academic performance from adults born at term and not SGA.

METHODS

As part of the Helsinki Study of Very Low Birth Weight Adults, 103 VLBW (37 SGA) and 105 term-born control adults (mean age 25.0, range 21.4-29.7 years) without major neurosensory impairments participated in the follow-up study in 2007-2008. The test battery included measures of general cognitive ability as well as executive functioning and related abilities. Academic performance was self-reported.

RESULTS

With adjustment for sex and age, the VLBW group scored lower or performed slower than the control group in some indices of all tests (these mean differences ranged from 0.3 to 0.5 SD units, p ≤ 0.03) and they had received remedial education at school more frequently; however, no differences existed in self-reported academic performance. The differences were evident in both VLBW-SGA and VLBW-AGA groups. Further covariate adjustments for parental education, current head circumference, and head circumference at birth and, in tests of executive functioning and related abilities, adjustment for IQ estimate had minor effects on the results.

CONCLUSIONS

In comparison with control adults, VLBW adults scored lower on several neurocognitive tests. Poorer neurocognitive performance is associated with VLBW irrespective of the intrauterine growth pattern.

摘要

目的

尽管严重的早产儿出生与儿童神经认知能力受损有关,但成年后的随访研究却很少。我们旨在研究极低出生体重(VLBW)(<1500 克)的成年人,无论是小于胎龄(SGA)(出生体重≤-2SD)还是适合胎龄(AGA),在一系列神经认知能力和学业成绩方面是否与足月出生且非 SGA 的成年人存在差异。

方法

作为赫尔辛基极低出生体重成年人研究的一部分,103 名 VLBW(37 名 SGA)和 105 名足月出生的对照组成年人(平均年龄 25.0 岁,范围 21.4-29.7 岁)参加了 2007-2008 年的随访研究,他们没有重大神经感觉障碍。测试包包括一般认知能力以及执行功能和相关能力的测量。学业成绩由自己报告。

结果

在调整性别和年龄后,VLBW 组在所有测试的某些指标上的得分低于或表现慢于对照组(这些平均差异范围为 0.3 至 0.5 个标准差单位,p≤0.03),他们在学校接受过更多的补救教育;然而,在自我报告的学业成绩方面没有差异。这些差异在 VLBW-SGA 和 VLBW-AGA 组中都存在。进一步对父母教育、当前头围、出生时头围以及在执行功能和相关能力测试中对智商估计进行协变量调整,对结果的影响较小。

结论

与对照组成年人相比,VLBW 成年人在多项神经认知测试中得分较低。无论宫内生长模式如何,较差的神经认知表现都与 VLBW 有关。

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