Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Pediatrics. 2013 Jul;132(1):e61-9. doi: 10.1542/peds.2012-3121.
To compare the prevalence of and characteristics associated with early intervention (EI) program enrollment among infants born late preterm (34–36 weeks’ gestation), early term (37–38 weeks’ gestation), and term (39–41 weeks’ gestation).
A Massachusetts cohort of 554 974 singleton infants born during 1998 through 2005 and survived the neonatal period was followed until the third birthday of each infant. Data came from the Pregnancy to Early Life Longitudinal Data System that linked birth certificates, birth hospital discharge reports, death certificates, and EI program enrollment records. We calculated prevalence and adjusted risk ratios to compare differences and understand associations.
The prevalence of EI program enrollment increased with each decreasing week of gestation before 41 weeks (late preterm [23.5%],early term [14.9%], and term [11.9%]. In adjusted analyses, the strongest predictors of EI enrollment (adjusted risk ratio ≥1.20) for all gestational age groups were male gender, having a congenital anomaly, and having mothers who were ≥40 years old, non high school graduates, and recipients of public insurance.
Infants born late preterm and early term have higher prevalence of EI program services enrollment than infants born at term,and may benefit from more frequent monitoring for developmental delays or disabilities.
比较孕晚期早产儿(34-36 周)、早期足月产儿(37-38 周)和足月产儿(39-41 周)早期干预(EI)项目入组的流行率及其特征。
一项对 1998 年至 2005 年间在马萨诸塞州出生且在新生儿期存活的 554974 名单胎婴儿的队列研究,随访至每个婴儿 3 岁生日。数据来自妊娠到早期生命纵向数据系统,该系统将出生证明、分娩医院出院报告、死亡证明和 EI 项目登记记录联系起来。我们计算了流行率,并调整了风险比来比较差异和理解关联。
在 41 周之前,每周的胎龄越小,EI 项目入组的比例越高(孕晚期早产儿为 23.5%,早期足月产儿为 14.9%,足月产儿为 11.9%)。在调整分析中,所有胎龄组中,EI 入组的最强预测因素(调整风险比≥1.20)为男性、先天性异常和母亲年龄≥40 岁、未高中毕业、接受公共保险。
与足月产儿相比,孕晚期早产儿和早期足月产儿的 EI 项目服务入组率更高,可能需要更频繁地监测发育迟缓或残疾。