Fevang Silje Katrine Elgen, Hysing Mari, Markestad Trond, Sommerfelt Kristian
Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Department of Pediatrics, Haukeland University Hospital, Bergen, Norway; and
Uni Research Health, Regional Centre for Child and Youth Mental Health and Child Welfare, Bergen, Norway.
Pediatrics. 2016 Apr;137(4). doi: 10.1542/peds.2015-3002. Epub 2016 Mar 4.
To describe the prevalence and gender characteristics of mental health problems in extremely preterm/extremely low birth weight (EP/ELBW) children without intellectual disabilities, blindness, deafness, or severe cerebral palsy compared with a reference group at 11 years of age.
In a national cohort of EP/ELBW children, mental health was assessed by parental and teacher report by using the Autism Spectrum Screening Questionnaire, the Swanson, Noland, and Pelham Questionnaire IV (attention-deficit/hyperactivity disorder), the Screen for Child Anxiety Related Emotional Disorders, symptoms of obsessive-compulsive disorder (OCD), and a total difficulties score from the Strength and Difficulties Questionnaire. Pervasive rating was defined as both parent and teacher scoring the child ≥95th percentile (≥90th percentile for total difficulties score) of the reference group, which was the population-based Bergen Child Study.
Of eligible children, 216 (64%) EP/ELBW and 1882 (61%) reference children participated. EP/ELBW children were at significantly increased risk of pervasive rated symptoms of autism (odds ratio 4.3, 95% confidence interval 2.0-9.3), inattention (8.3, 4.4-15), anxiety (2.3, 1.4-3.7), OCD (2.6, 1.4-3.7), and ≥90th percentile for total difficulties score (4.9, 2.9-8.2). Reported by either parents or teachers, 54% of the EP/ELBW and 21% of the reference children had ≥1 mental health problem (odds ratio 4.5, 95% confidence interval 3.3-6.1). There were no significant interactions between EP/ELBW and gender in mental health outcomes.
EP/ELBW children without severe disabilities had increased risk of symptoms of autism, inattention, anxiety, and OCD. Gender differences were comparable to the reference group.
描述与11岁时的参照组相比，无智力残疾、失明、失聪或严重脑瘫的极早产儿/极低出生体重（EP/ELBW）儿童心理健康问题的患病率及性别特征。
在一个全国性的EP/ELBW儿童队列中，通过家长和教师使用《自闭症谱系筛查问卷》《斯旺森、诺兰德和佩勒姆问卷IV》（注意力缺陷多动障碍）、《儿童焦虑相关情绪障碍筛查量表》、强迫症（OCD）症状以及《长处与困难问卷》的总困难得分来评估心理健康状况。普遍评分定义为家长和教师对儿童的评分均处于参照组的第95百分位数及以上（总困难得分处于第90百分位数及以上），参照组为基于人群的卑尔根儿童研究。
在符合条件的儿童中，216名（64%）EP/ELBW儿童和1882名（61%）参照组儿童参与了研究。EP/ELBW儿童出现自闭症普遍评分症状（优势比4.3，95%置信区间2.0 - 9.3）、注意力不集中（8.3，4.4 - 15）、焦虑（2.3，1.4 - 3.7）、强迫症（2.6，1.4 - 3.7）以及总困难得分处于第90百分位数及以上（4.9，2.9 - 8.2）的风险显著增加。家长或教师报告显示，54%的EP/ELBW儿童和21%的参照组儿童存在≥1种心理健康问题（优势比4.5，95%置信区间3.3 - 6.1）。在心理健康结果方面，EP/ELBW与性别之间不存在显著交互作用。
无严重残疾的EP/ELBW儿童出现自闭症、注意力不集中、焦虑和强迫症症状的风险增加。性别差异与参照组相当。
