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晚期早产儿的神经认知结局。

Neurocognitive outcome in young adults born late-preterm.

机构信息

Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.

Folkhälsan Research Center, Helsinki, Finland.

出版信息

Dev Med Child Neurol. 2018 Mar;60(3):267-274. doi: 10.1111/dmcn.13616. Epub 2017 Nov 27.

Abstract

AIM

This study examined whether late-preterm birth (34+0 to 36+6wks+d gestational age) was associated with neurocognitive deficit in young adulthood, and whether small for gestational age (SGA) birth amplified any adversity.

METHOD

Participants derived from the prospective regional cohort study, the Arvo Ylppö Longitudinal Study (n=786; 398 females, 388 males) (mean age 25y 4mo, SD 8mo), born 1985 to 1986 late-preterm (n=119; 21 SGA, <-2 SD) and at term (37+0 to 41+6wks+d; n=667; 28 SGA) underwent tests of intelligence, executive functioning, attention, and memory, and reported their education.

RESULTS

Those born late-preterm scored -3.71 (95% confidence interval [CI] -6.71 to -0.72) and -3.11 (95% CI -6.01 to -0.22) points lower on Full-scale and Verbal IQ than peers born at term. Compared with those born at term and appropriate for gestational age (≥-2 to <2 SD) Full-scale, Verbal, and Performance IQ scores of those born late-preterm and SGA were -9.45 to -11.84 points lower. After adjustments, differences were rendered non-significant, except that scores in Full-scale and Performance IQ remained lower among those born late-preterm and SGA.

INTERPRETATION

Late-preterm birth, per se, may not increase the risk of poorer neurocognitive functioning in adulthood. But the double burden of being born late-preterm and SGA seems to increase this risk.

WHAT THIS PAPER ADDS

Late-preterm birth did not increase the risk of poorer neurocognitive functioning in adulthood. But the double burden of being born late-preterm and being small for gestational age did increase this risk.

摘要

目的

本研究旨在探讨晚期早产儿(34+0 周至 36+6 周+天的胎龄)是否与成年后的神经认知缺陷有关,以及宫内生长受限(SGA)出生是否放大了任何不利因素。

方法

参与者来自前瞻性区域队列研究,Arvo Ylppö 纵向研究(n=786;398 名女性,388 名男性)(平均年龄 25 岁 4 个月,SD 8 个月),1985 年至 1986 年出生的晚期早产儿(n=119;21 名 SGA,<-2 SD)和足月(37+0 周至 41+6 周+天;n=667;28 名 SGA)接受了智力、执行功能、注意力和记忆测试,并报告了他们的教育程度。

结果

与足月出生的同龄人相比,晚期早产儿的全量表和言语智商得分分别低-3.71(95%置信区间[CI] -6.71 至-0.72)和-3.11(95% CI -6.01 至-0.22)分。与足月且符合生长标准(≥-2 至<2 SD)的婴儿相比,晚期早产儿和 SGA 出生的婴儿的全量表、言语和表现智商得分低-9.45 至-11.84 分。调整后,差异不再显著,除了晚期早产儿和 SGA 出生的婴儿全量表和表现智商得分仍较低外。

结论

晚期早产儿出生本身可能不会增加成年后神经认知功能下降的风险。但晚期早产儿和 SGA 出生的双重负担似乎增加了这种风险。

本文的贡献

晚期早产儿出生本身不会增加成年后神经认知功能下降的风险。但晚期早产儿和 SGA 出生的双重负担确实增加了这种风险。

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