Shah Prachi, Kaciroti Niko, Richards Blair, Oh Wonjung, Lumeng Julie C
Division of Developmental Behavioral Pediatrics, Department of Pediatrics, School of Medicine, Center for Human Growth and Development, and
Center for Human Growth and Development, and.
Pediatrics. 2016 Aug;138(2). doi: 10.1542/peds.2015-3496.
To compare developmental outcomes of late preterm infants (34-36 weeks' gestation) with infants born at early term (37-38 weeks' gestation) and term (39-41 weeks' gestation), from infancy through kindergarten.
Sample included 1000 late preterm, 1800 early term, and 3200 term infants ascertained from the Early Childhood Longitudinal Study, Birth Cohort. Direct assessments of development were performed at 9 and 24 months by using the Bayley Short Form-Research Edition T-scores and at preschool and kindergarten using the Early Childhood Longitudinal Study, Birth Cohort reading and mathematics θ scores. Maternal and infant characteristics were obtained from birth certificate data and parent questionnaires. After controlling for covariates, we compared mean developmental outcomes between late preterm and full-term groups in serial cross-sectional analyses at each timepoint using multilinear regression, with pairwise comparisons testing for group differences by gestational age categories.
With covariates controlled at all timepoints, at 9 months late preterm infants demonstrated less optimal developmental outcomes (T = 47.31) compared with infants born early term (T = 49.12) and term (T = 50.09) (P < .0001). This association was not seen at 24 months, (P = .66) but reemerged at preschool. Late preterm infants demonstrated less optimal scores in preschool reading (P = .0006), preschool mathematics (P = .0014), and kindergarten reading (P = .0007) compared with infants born at term gestation.
Although late preterm infants demonstrate comparable developmental outcomes to full-term infants (early term and full-term gestation) at 24 months, they demonstrate less optimal reading outcomes at preschool and kindergarten timepoints. Ongoing developmental surveillance for late preterm infants is warranted into preschool and kindergarten.
比较晚期早产儿(妊娠34 - 36周)与早期足月儿(妊娠37 - 38周)及足月儿(妊娠39 - 41周)从婴儿期到幼儿园阶段的发育结局。
样本包括从儿童早期纵向研究出生队列中确定的1000名晚期早产儿、1800名早期足月儿和3200名足月儿。在9个月和24个月时使用贝利简式研究版T分数对发育进行直接评估,在学龄前和幼儿园阶段使用儿童早期纵向研究出生队列的阅读和数学θ分数进行评估。母亲和婴儿的特征来自出生证明数据和家长问卷。在控制协变量后,我们在每个时间点使用多线性回归在系列横断面分析中比较晚期早产儿和足月儿组之间的平均发育结局,并通过成对比较检验不同胎龄类别的组间差异。
在所有时间点控制协变量后,9个月时晚期早产儿的发育结局不如早期足月儿(T = 49.12)和足月儿(T = 50.09)理想(T = 47.31)(P < .0001)。这种关联在24个月时未出现(P = .66),但在学龄前再次出现。与足月儿相比,晚期早产儿在学龄前阅读(P = .0006)、学龄前数学(P = .0014)和幼儿园阅读(P = .0007)方面的得分较低。
尽管晚期早产儿在24个月时的发育结局与足月儿(早期足月儿和足月儿)相当,但在学龄前和幼儿园阶段,他们的阅读结局不太理想。对晚期早产儿进行持续的发育监测直至学龄前和幼儿园阶段是有必要的。