Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Pediatrics. 2013 Sep;132(3):e630-6. doi: 10.1542/peds.2012-3588. Epub 2013 Aug 26.
Previous studies suggest that former late preterm infants are at increased risk for learning and behavioral problems compared with term infants. These studies have primarily used referred clinical samples of children followed only until early school age. Our objective was to determine the cumulative incidence of attention deficit/hyperactivity disorder (ADHD) and learning disabilities (LD) in former late preterm versus term infants in a population-based birth cohort.
Subjects included all children born 1976 to 1982 in Rochester, MN who remained in the community after 5 years. This study focused on the comparison of subjects in 2 subgroups, late preterm (34 to <37 weeks) and term (37 to <42 weeks). School and medical records were available to identify individuals who met research criteria for ADHD and LD in reading, written language, and math. The Kaplan-Meier method was used to estimate the cumulative incidence of each condition by 19 years of age. Cox models were fit to evaluate the association between gestational age group and condition, after adjusting for maternal education and perinatal complications.
We found no statistically significant differences in the cumulative incidence of ADHD or LD between the late preterm (N = 256) versus term (N = 4419) groups: ADHD (cumulative incidence by age 19 years, 7.7% vs 7.2%; P = .84); reading LD (14.2% vs 13.1%; P = .57); written language LD (13.5% vs 15.7%; P = .36), and math LD (16.1% vs 15.5%; P = .89).
These data from a population-based birth cohort indicate that former late preterm infants have similar rates of LD and ADHD as term infants.
先前的研究表明,与足月婴儿相比,前晚期早产儿在学习和行为问题方面的风险增加。这些研究主要使用了接受过临床转诊的儿童样本,这些儿童仅在早期学龄时接受了随访。我们的目的是在一个基于人群的出生队列中,确定前晚期早产儿与足月婴儿相比,注意缺陷/多动障碍(ADHD)和学习障碍(LD)的累积发病率。
研究对象包括 1976 年至 1982 年在明尼苏达州罗切斯特出生并在 5 岁后仍留在社区的所有儿童。本研究重点比较了 2 个亚组的受试者,晚期早产儿(34 至<37 周)和足月(37 至<42 周)。学校和医疗记录可用于确定符合 ADHD 和阅读、书面语言和数学 LD 研究标准的个体。使用 Kaplan-Meier 方法估计到 19 岁时每种情况的累积发病率。Cox 模型用于在调整了母亲教育和围产期并发症后,评估胎龄组与疾病之间的关联。
我们发现晚期早产儿(N=256)与足月(N=4419)组之间 ADHD 或 LD 的累积发病率没有统计学上的显著差异:ADHD(19 岁时的累积发病率,7.7%对 7.2%;P=0.84);阅读 LD(14.2%对 13.1%;P=0.57);书面语言 LD(13.5%对 15.7%;P=0.36)和数学 LD(16.1%对 15.5%;P=0.89)。
本基于人群的出生队列研究数据表明,前晚期早产儿的 LD 和 ADHD 发生率与足月婴儿相似。