Peralta-Carcelen Myriam, Carlo Waldemar A, Pappas Athina, Vaucher Yvonne E, Yeates Keith Owen, Phillips Vivien A, Gustafson Kathryn E, Payne Allison H, Duncan Andrea F, Newman Jamie E, Bann Carla M
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama;
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
Pediatrics. 2017 Jun;139(6). doi: 10.1542/peds.2016-1043.
Behavior and socioemotional development are crucial aspects of child development .
A total of 2505 children born at <27 weeks' gestation was evaluated at 18 to 22 months' corrected age between January 1, 2008 and December 12, 2012 (86% follow-up). The Brief Infant and Toddler Social and Emotional Assessment was used to evaluate behavioral and socioemotional problems. Cognition and language were evaluated by using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Logistic regression analysis was used to evaluate for perinatal and demographic factors associated with behavioral problems (≥75th percentile) and delayed socioemotional competence (≤15th percentile). Structural equation modeling with bootstrapping was used to identify possible associated risk factors and Bayley-III scores as mediators.
Thirty-five percent (873) of children had behavioral problems, and 26% (637) displayed deficits in socioemotional competence. Male sex, public insurance, mothers with less than a high school education, and lower maternal age were associated with behavioral problems. Deficits in competence were associated with lower birth weight, public insurance, mothers with less than a high school education, and abnormal neuromotor exam. Bayley-III language and cognitive scores were significant mediators of the relationships between risk factors and both behavioral and competence scores ( < .05).
Extremely premature children are at risk for behavioral problems and deficits in socioemotional competence. Sociodemographic factors were associated with both socioemotional competence and behavioral problems. Deficits in socioemotional competence were also associated with neuromotor abnormalities and cognitive and language function.
行为和社会情感发展是儿童发育的关键方面。
对2008年1月1日至2012年12月12日期间出生时孕周小于27周的2505名儿童在矫正年龄18至22个月时进行评估（随访率86%）。使用《婴幼儿社会和情感简短评估量表》评估行为和社会情感问题。使用贝利婴幼儿发展量表第三版（贝利-III）评估认知和语言能力。采用逻辑回归分析评估与行为问题（≥第75百分位数）和社会情感能力延迟（≤第15百分位数）相关的围产期和人口统计学因素。采用带有自抽样法的结构方程模型来确定可能的相关风险因素以及将贝利-III评分作为中介变量。
35%（873名）儿童存在行为问题，26%（637名）表现出社会情感能力缺陷。男性、公共保险、母亲受教育程度低于高中以及母亲年龄较小与行为问题相关。能力缺陷与低出生体重、公共保险、母亲受教育程度低于高中以及神经运动检查异常相关。贝利-III语言和认知评分是风险因素与行为评分和能力评分之间关系的显著中介变量（P<0.05）。
极早产儿存在行为问题和社会情感能力缺陷的风险。社会人口统计学因素与社会情感能力和行为问题均相关。社会情感能力缺陷还与神经运动异常以及认知和语言功能相关。
