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早产后的婴儿生长及成年早期的神经认知能力。

Infant growth after preterm birth and neurocognitive abilities in young adulthood.

作者信息

Sammallahti Sara, Pyhälä Riikka, Lahti Marius, Lahti Jari, Pesonen Anu-Katriina, Heinonen Kati, Hovi Petteri, Eriksson Johan G, Strang-Karlsson Sonja, Andersson Sture, Järvenpää Anna-Liisa, Kajantie Eero, Räikkönen Katri

机构信息

Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.

Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.

出版信息

J Pediatr. 2014 Dec;165(6):1109-1115.e3. doi: 10.1016/j.jpeds.2014.08.028. Epub 2014 Sep 26.

Abstract

OBJECTIVES

To examine whether faster growth from birth to term (40 postmenstrual weeks) and during the first year thereafter was associated with better neurocognitive abilities in adults born preterm with very low birth weight (VLBW; <1500 g).

STUDY DESIGN

Weight, length, and head circumference data of 103 VLBW participants of the Helsinki Study of Very Low Birth Weight Adults were collected from records. Measures at term and at 12 months of corrected age were interpolated. The participants underwent tests of general neurocognitive ability, executive functioning, attention, and visual memory at mean age of 25.0 years.

RESULTS

Faster growth from birth to term was associated with better general neurocognitive abilities, executive functioning, and visual memory in young adulthood. Effect sizes in SD units ranged from 0.23-0.43 per each SD faster growth in weight, length, or head circumference (95% CI 0.003-0.64; P values <.05). After controlling for neonatal complications, faster growth in head circumference remained more clearly associated with neurocognitive abilities than weight or length did. Growth during the first year after term was not consistently associated with neurocognitive abilities.

CONCLUSIONS

Within a VLBW group with high variability in early growth, faster growth from birth to term is associated with better neurocognitive abilities in young adulthood. Neurocognitive outcomes were predicted, in particular, by early postnatal head growth.

摘要

目的

探讨从出生到足月(孕40周)以及此后第一年更快的生长速度是否与极低出生体重(VLBW;<1500g)早产出生的成年人更好的神经认知能力相关。

研究设计

从记录中收集了赫尔辛基极低出生体重成年人研究中103名VLBW参与者的体重、身长和头围数据。推算出足月时和矫正年龄12个月时的测量值。参与者在平均年龄25.0岁时接受了一般神经认知能力、执行功能、注意力和视觉记忆测试。

结果

从出生到足月更快的生长速度与成年早期更好的一般神经认知能力、执行功能和视觉记忆相关。体重、身长或头围每快一个标准差,效应量以标准差单位计为0.23 - 0.43(95%可信区间0.003 - 0.64;P值<0.05)。在控制了新生儿并发症后,头围更快的生长与神经认知能力的关联比体重或身长更明显。足月后第一年的生长与神经认知能力没有一致的关联。

结论

在早期生长差异较大的VLBW组中,从出生到足月更快的生长速度与成年早期更好的神经认知能力相关。神经认知结果尤其由出生后早期的头部生长预测。

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