Kitchen W H, Ford G W, Rickards A L, Lissenden J V, Ryan M M
J Pediatr. 1987 Feb;110(2):283-8. doi: 10.1016/s0022-3476(87)80174-9.
Of 55 consecutive long-term survivors of birth weight 500 to 999 g, complete psychologic and pediatric data were available for 54 children at 2 years corrected age and for 50 at age at least 5 1/2 years. At the latter age, 60% (30 of 50) were not impaired, 10% (five of 50) had severe sensorineural or intellectual impairments, 10% (five of 50) had mild to moderately impairment, and 20% (10 of 50) had minor neurobehavioural abnormalities. Sensorineural deafness in one child and bilateral blindness in one remained stable over time, but of six children with spastic cerebral palsy at 2 years, only three retained this diagnosis at 5 1/2 years. The mean Mental Developmental Index (MDI) on the Bayley Scales at 2 years was 91.1, significantly below the test mean; by 5 1/2 years the mean full scale of the Wechsler Preschool and Primary Scales of Intelligence (WPPSI) was 101.8. The MDI correlated highly with the full-scale WPPSI (r = 0.7), but for individual children it was not always an accurate predictor of 5-year ability. Between 2 and 5 1/2 years there was a substantial reordering within four categories of impairment: findings in 27 children were improved, four were judged to become more severely impaired over time, and 19 did not change. We conclude that our 2-year assessment often underrated the potential of the children as expressed at 5 1/2 years, and that 2 years is too early for reliable classification of children of birth weight 500 to 999 g.
在55名出生体重为500至999克的连续长期存活者中，有54名儿童在矫正年龄2岁时可获得完整的心理和儿科数据，50名儿童在至少5岁半时可获得相关数据。在5岁半时，60%（50名中的30名）没有受损，10%（50名中的5名）有严重的感觉神经性或智力障碍，10%（50名中的5名）有轻度至中度损伤，20%（50名中的10名）有轻微的神经行为异常。一名儿童的感觉神经性耳聋和一名儿童的双侧失明随时间保持稳定，但在2岁时有6名痉挛性脑瘫儿童，到5岁半时只有3名仍维持该诊断。2岁时贝利量表的平均心理发展指数（MDI）为91.1，显著低于测试均值；到5岁半时，韦氏学前及初小儿童智力量表（WPPSI）的平均全量表分为101.8。MDI与WPPSI全量表高度相关（r = 0.7），但对于个体儿童而言，它并不总是5岁能力的准确预测指标。在2岁至5岁半之间，四类损伤情况中有大量重新排序：27名儿童的情况有所改善，4名儿童被判定随时间变得损伤更严重，19名儿童没有变化。我们得出结论，我们的2岁评估往往低估了儿童在5岁半时所表现出的潜力，而且对于出生体重500至999克的儿童，2岁进行可靠分类为时过早。
