Scharf Rebecca J, Stroustrup Annemarie, Conaway Mark R, DeBoer Mark D
Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA.
Division of Newborn Medicine, Department of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Arch Dis Child Fetal Neonatal Ed. 2016 Sep;101(5):F433-8. doi: 10.1136/archdischild-2015-309427. Epub 2015 Dec 1.
To examine the relationships between growth (birth to age 2 years) and developmental outcomes in children born with very low birthweight (VLBW).
Motor and mental development in children born with VLBW were regressed on anthropometric measurements at birth, 9 months and 2 years using multivariable regression.
The Early Childhood Longitudinal Study-Birth Cohort, a longitudinal cohort, community sample, designed to be representative of children born across the USA.
950 children born with VLBW (<1500 g).
Motor and cognitive scores on the Bayley Scales at 9 months and 24 months chronological age.
A high proportion of children exhibited poor growth, with length-for-age z-scores <-2 (ie, stunting) in 21.3% of children at 9 months (adjusted for prematurity) and 34.2% of children at 2 years. Compared with children having z-scores >-2, children with growth shortfalls in head circumference, length and weight had a higher adjusted OR (aOR) of low Bayley motor scores at 9 months and 2 years (aOR ranging from 1.8 to 3.3, all p<0.05), while low Bayley cognitive scores were predicted by 9-month deficits in length and weight (aOR 2.0 and 2.4, respectively, both p<0.01) and 2-year deficits in length and head circumference (aOR 2.9 and 2.8, both p<0.05).
Anthropometric measures of growth were linked to current and future neurodevelopmental outcomes in children born with VLBW. While careful length measures may be a particularly useful marker, deficits in all anthropometric measures were risk factors for developmental delays.
研究极低出生体重（VLBW）儿从出生至2岁的生长情况与发育结局之间的关系。
采用多变量回归分析，以出生时、9个月和2岁时的人体测量数据为自变量，对VLBW儿的运动和智力发育情况进行回归分析。
儿童早期纵向研究-出生队列，这是一项纵向队列社区样本研究，旨在代表全美国出生的儿童。
950例VLBW儿（出生体重<1500g）。
按实际年龄9个月和24个月时的贝利婴幼儿发育量表运动和认知评分。
很大一部分儿童生长情况不佳，9个月时（校正早产因素后）21.3%的儿童年龄别身长Z评分<-2（即发育迟缓），2岁时这一比例为34.2%。与Z评分>-2的儿童相比，头围、身长和体重生长不足的儿童在9个月和2岁时贝利运动评分较低的校正比值比（aOR）更高（aOR范围为1.8至3.3，均p<0.05），而9个月时身长和体重不足以及2岁时身长和头围不足可预测贝利认知评分较低（aOR分别为2.0和2.4，均p<0.01；aOR分别为2.9和2.8，均p<0.05）。
VLBW儿的人体测量生长指标与当前及未来的神经发育结局相关。虽然精确的身长测量可能是一个特别有用的指标，但所有人体测量指标的不足都是发育迟缓的危险因素。
