Oei Ju Lee, Melhuish Edward, Uebel Hannah, Azzam Nadin, Breen Courtney, Burns Lucinda, Hilder Lisa, Bajuk Barbara, Abdel-Latif Mohamed E, Ward Meredith, Feller John M, Falconer Janet, Clews Sara, Eastwood John, Li Annie, Wright Ian M
School of Women's and Children's Health,
Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia.
Pediatrics. 2017 Feb;139(2). doi: 10.1542/peds.2016-2651. Epub 2017 Jan 16.
Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1).
Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7.
Mean test scores (range 0-1000) for children with NAS were significantly lower in grade 3 (359 vs control: 410 vs population: 421). The deficit was progressive. By grade 7, children with NAS scored lower than other children in grade 5. The risk of not meeting minimum standards was independently associated with NAS (adjusted odds ratio [aOR], 2.5; 95% confidence interval [CI], 2.2-2.7), indigenous status (aOR, 2.2; 95% CI, 2.2-2.3), male gender (aOR, 1.3; 95% CI, 1.3-1.4), and low parental education (aOR, 1.5; 95% CI, 1.1-1.6), with all Ps < .001.
A neonatal diagnostic code of NAS is strongly associated with poor and deteriorating school performance. Parental education may decrease the risk of failure. Children with NAS and their families must be identified early and provided with support to minimize the consequences of poor educational outcomes.
对于被诊断为新生儿戒断综合征（NAS）（《国际疾病和相关问题统计分类》[第10版]，澳大利亚修订版，P96.1）的儿童的长期结局，包括学业方面的结局，我们了解甚少。
对2000年至2006年在澳大利亚新南威尔士州（NSW）出生的所有儿童的健康和基于课程的测试数据进行关联分析。将患有NAS的儿童（n = 2234）与在孕周、社会经济地位和性别方面匹配的对照组（n = 4330，对照组）以及新南威尔士州的其他儿童（n = 598265，总体人群）进行比较，以获取他们在三年级、五年级和七年级的全国评估计划：读写和算术测试结果。
患有NAS的儿童在三年级时的平均测试分数（范围为0 - 1000）显著低于对照组（359分对对照组：410分对总体人群：421分）。这种差距呈渐进性。到七年级时，患有NAS的儿童的分数低于五年级的其他儿童。未达到最低标准的风险与NAS独立相关（调整后的优势比[aOR]，2.5；95%置信区间[CI]，2.2 - 2.7）、原住民身份（aOR，2.2；95% CI，2.2 - 2.3）、男性性别（aOR，1.3；95% CI，1.3 - 1.4）以及父母低教育水平（aOR，1.5；95% CI，1.1 - 1.6），所有P值均<0.001。
NAS的新生儿诊断编码与学业成绩差及成绩恶化密切相关。父母教育可能会降低不及格的风险。必须尽早识别患有NAS的儿童及其家庭，并为他们提供支持，以尽量减少不良教育结局的后果。
