de Mello Rosane Reis, Rodrigues Reis Ana Beatriz, da Silva Kátia Silveira
MD, PhD. Attending Physician, Department of Neonatology, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fiocruz, Rio de Janeiro (RJ), Brazil.
MSc. Clinical Psychologist, Department of Neonatology, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fiocruz, Rio de Janeiro (RJ), Brazil.
Sao Paulo Med J. 2017 Jul-Aug;135(4):383-390. doi: 10.1590/1516-3180.2017.0010190317. Epub 2017 Jul 31.
: Children born prematurely often have worse cognitive performance than those born at term regarding skills such as memory, attention and processing speed. Bronchopulmonary dysplasia may compromise cognitive development. The aims here were: a) To describe the cognitive performance of preterm infants with very low birth weight; b) To investigate its association with bronchopul-monary dysplasia adjusted for sociodemographic, neonatal and post-neonatal factors.
: Cross-sectional study developed in a public tertiary-care hospital.
: To evaluate cognition among 112 children, we applied an intelligence scale (Wechsler scale). The average scores for children with and without bronchopulmonary dysplasia were compared across the fve domains of the scale. Associations with bronchopulmonary dysplasia were investigated for domains that showed signifcant diferences between the two groups. Associations between exposure and outcome were estimated via multivariate logistic regression.
: There were no diferences in averages for the full-scale intelligence quotient, verbal intelligence quotient, performance intelligence quotient and general language composite domains. The processing speed quotient was the only domain that presented a signifcant diference between the two groups (P = 0.02). Among the children with bronchopulmonary dysplasia, low full-scale intelligence quotient was observed in 28.1%. In the multivariate analysis, bronchopulmonary dysplasia (odds ratio: 3.1; 95conf-dence interval: 1.1-8.7) remained associated with the outcome of processing speed quotient.
: Bronchopulmonary dysplasia was an independent risk factor for alteration of the processing speed quotient.
早产出生的儿童在记忆、注意力和处理速度等技能方面的认知表现往往比足月出生的儿童差。支气管肺发育不良可能会损害认知发展。本研究的目的是：a）描述极低出生体重早产儿的认知表现；b）调查其与经社会人口统计学、新生儿和新生儿后期因素调整后的支气管肺发育不良之间的关联。
在一家公立三级护理医院开展的横断面研究。
为评估112名儿童的认知情况，我们应用了一种智力量表（韦氏智力量表）。在该量表的五个领域中比较了有和没有支气管肺发育不良的儿童的平均得分。对两组之间显示出显著差异的领域调查其与支气管肺发育不良的关联。通过多变量逻辑回归估计暴露与结果之间的关联。
在全量表智商、言语智商、操作智商和一般语言综合领域的平均值方面没有差异。处理速度商数是两组之间唯一呈现显著差异的领域（P = 0.02）。在患有支气管肺发育不良的儿童中，观察到28.1%的儿童全量表智商较低。在多变量分析中，支气管肺发育不良（比值比：3.1；95%置信区间：1.1 - 8.7）仍然与处理速度商数的结果相关。
支气管肺发育不良是处理速度商数改变的独立危险因素。
