Tohoku University Hospital.
Tohoku J Exp Med. 2014 Jan;232(1):27-33. doi: 10.1620/tjem.232.27.
In recent years, there has been an increase in the number of infants with very low birth weight (VLBW, i.e., weight less than 1,500 g) in Japan. However, the effect of VLBW on subsequent behavioral development and mental health remains unknown. Subjects enrolled were 57 individuals (13.4 ± 1.9 years old) with VLBW (VLBW group), including 23 small-for-gestational-age (SGA) infants (i.e., the SGA/VLBW group) and 34 appropriate-for-gestational-age (AGA) infants (the AGA/VLBW group). The control group was 29 individuals born AGA at term. We used the questionnaires, the Pupil Rating Scale Revised (PRS) to screen for learning disabilities and the Children's Depression Inventory (CDI) to examine the presence of depression. The PRS score in the VLBW group was significantly lower than that of the control group (p < 0.001). Suspected learning disabilities (LD, defined by a score below 65 points on the PRS) were found in 6 out of the 56 subjects in the VLBW group (10.7%), whereas none were found in the 29 control subjects (p = 0.074). The frequency of suspected LD children was higher in the SGA/VLBW group (4 out of 22 evaluated infants, 18.2%) than that in the AGA/VLBW group (2/34, 5.9%). The frequency of suspected LD in the non-verbal field was significantly higher (p = 0.02) in the SGA/VLBW group (18.2%) than in the AGA/VLBW group (0%). However, CDI score did not significantly differ between groups. These findings suggest that VLBW and fetal growth restriction may pose a risk for LD among adolescents with VLBW.
近年来，日本极低出生体重儿（VLBW，即体重不足 1500 克）的数量有所增加。然而，VLBW 对后续行为发育和心理健康的影响尚不清楚。本研究纳入了 57 名 VLBW 婴儿（13.4±1.9 岁），包括 23 名小于胎龄儿（SGA，即 SGA/VLBW 组）和 34 名适于胎龄儿（AGA，即 AGA/VLBW 组）。对照组为 29 名足月出生的 AGA 婴儿。我们使用问卷、瞳孔反应量表修订版（PRS）筛查学习障碍，使用儿童抑郁量表（CDI）检查抑郁情况。VLBW 组的 PRS 评分明显低于对照组（p＜0.001）。在 VLBW 组的 56 名受试者中，有 6 名（10.7%）被怀疑存在学习障碍（LD，PRS 评分低于 65 分），而对照组 29 名受试者均无（p=0.074）。在 SGA/VLBW 组中，有 4 名（22 名评估婴儿中的 18.2%）疑似 LD 儿童，而在 AGA/VLBW 组中，仅有 2 名（34 名中的 5.9%）（p=0.02）。在非言语领域，SGA/VLBW 组疑似 LD 的频率显著更高（p=0.02）。然而，各组间 CDI 评分无显著差异。这些发现表明，VLBW 和胎儿生长受限可能使 VLBW 青少年面临 LD 的风险。
