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婴儿行为评估和干预方案对极低出生体重儿在 5.5 校正年龄时的持续发育影响。

Sustained developmental effects of the infant behavioral assessment and intervention program in very low birth weight infants at 5.5 years corrected age.

机构信息

Department of Rehabilitation, Academic Medical Center, University of Amsterdam, and Department of Neonatology, Emma's Children's Hospital, Amsterdam, The Netherlands.

出版信息

J Pediatr. 2013 Jun;162(6):1112-9. doi: 10.1016/j.jpeds.2012.11.078. Epub 2013 Jan 11.

Abstract

OBJECTIVE

To evaluate the effect of the Infant Behavioral Assessment and Intervention Program (IBAIP) in very low birth weight (VLBW) infants on cognitive, neuromotor, and behavioral development at 5.5 years corrected age (CA).

STUDY DESIGN

In a randomized controlled trial, 86 VLBW infants received post discharge IBAIP intervention until 6 months CA, and 90 VLBW infants received standard care. At 5.5 years CA, cognitive and motor development, and visual-motor integration were assessed with the Wechsler Preschool and Primary Scale of Intelligence, third Dutch version, the Movement Assessment Battery for Children, second edition, and the Developmental Test of Visual Motor Integration. Neurologic conditions were assessed with the neurologic examination according to Touwen, and behavior with the Strengths and Difficulties Questionnaire.

RESULTS

At 5.5 years CA, 69 children in the intervention and 67 children in the control group participated (response rate 77.3%). Verbal and performance IQ-scores<85 occurred significantly less often in the intervention than in the control group (17.9% vs 33.3%, P=.041, and 7.5% vs 21.2%, P=.023, respectively). However, after adjustment for differences, only the OR for performance IQ was significant: 0.24, 95% CI: 0.06-0.95. Adjusted mean scores on Wechsler Preschool and Primary Scale of Intelligence, third version subtasks block design and vocabulary, the Movement Assessment Battery for Children, second edition component aiming and catching, and the Developmental Test of Visual Motor Integration were significantly better in the intervention group. No intervention effect was found on the Strengths and Difficulties Questionnaire.

CONCLUSION

The IBAIP leads, 5 years after the early neurobehavioral intervention, to improvements on performance IQ, ball skills, and visual-motor integration at 5.5 years CA.

摘要

目的

评估婴儿行为评估与干预方案(IBAIP)对极低出生体重(VLBW)婴儿认知、神经运动和行为发展的影响,评估时间为校正后 5.5 岁。

研究设计

在一项随机对照试验中,86 名 VLBW 婴儿在出院后接受 IBAIP 干预直至 6 个月校正年龄(CA),90 名 VLBW 婴儿接受标准护理。在 5.5 岁 CA 时,使用韦氏学前和小学智力量表第三版、儿童运动评估量表第二版和发育性视觉运动整合测试评估认知和运动发育以及视觉运动整合。神经状况根据 Touwen 进行神经检查评估,行为使用长处和困难问卷评估。

结果

在 5.5 岁 CA 时,干预组有 69 名儿童和对照组有 67 名儿童参与(应答率为 77.3%)。与对照组相比,干预组言语和操作智商得分<85 的发生率显著较低(分别为 17.9%对 33.3%,P=.041,和 7.5%对 21.2%,P=.023)。然而,在调整差异后,只有操作智商的 OR 具有统计学意义:0.24,95%CI:0.06-0.95。干预组韦氏学前和小学智力量表第三版的分测验积木设计和词汇、儿童运动评估量表第二版的瞄准和接球成分、发育性视觉运动整合测试的平均得分均显著较高。在长处和困难问卷上未发现干预效果。

结论

早期神经行为干预 5 年后,IBAIP 导致 5.5 岁 CA 时操作智商、球技和视觉运动整合的改善。

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