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极早产儿的轻微神经功能障碍与运动功能、一般认知能力和行为的关系。

Minor neurological dysfunction and associations with motor function, general cognitive abilities, and behaviour in children born extremely preterm.

机构信息

Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.

出版信息

Dev Med Child Neurol. 2018 Aug;60(8):826-832. doi: 10.1111/dmcn.13738. Epub 2018 Mar 24.

Abstract

AIM

To study the prevalence of minor neurological dysfunction (MND) at 6 years of age in a cohort of children born extremely preterm without cerebral palsy (CP) and to investigate associations with motor function, cognitive abilities, and behaviour.

METHOD

This study assessed 80 children born at less than 27 weeks of gestation and 90 children born at term age between 2004 and 2007 at a mean age of 6 years 6 months. The assessments included a simplified version of the Touwen Infant Neurological Examination, the Movement Assessment Battery for Children, Second Edition (MABC-2), Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV), the Strengths and Difficulties Questionnaire (SDQ), and the parent version of the Five to Fifteen questionnaire.

RESULTS

Fifty-one of the children born preterm had normal neurology, 23 had simple MND, and six had complex MND compared with 88 who had normal neurology and two simple MND in the term-born group (p<0.001). There were significant differences between the children with normal neurology and MND in the preterm group in MABC-2-assessed motor function (p<0.001), general cognitive abilities with WISC-IV (p=0.005), and SDQ overall behavioural problems and peer problems reported by the parents (p=0.021 and p=0.003 respectively). SDQ teacher-reported overall behavioural and hyperactivity problems were significantly different between children with normal and simple MND (p=0.036 and p=0.019).

INTERPRETATION

Children born extremely preterm, in the absence of CP, are at risk of MND and this is associated with motor function, cognitive ability, and behaviour.

WHAT THIS PAPER ADDS

Extremely preterm birth carries a risk of minor neurological dysfunction (MND). MND in children born extremely preterm is associated with impaired motor function and cognitive abilities, and behavioural problems. Male sex is associated with MND in children born extremely preterm.

摘要

目的

研究无脑瘫(CP)的极早产儿在 6 岁时轻度神经功能障碍(MND)的患病率,并探讨其与运动功能、认知能力和行为的关系。

方法

本研究评估了 2004 年至 2007 年间出生的小于 27 周龄的 80 名早产儿和足月出生的 90 名儿童,平均年龄为 6 岁 6 个月。评估包括简化版 Touwen 婴儿神经检查、第二代运动评估电池(MABC-2)、韦氏儿童智力量表第四版(WISC-IV)、长处与困难问卷(SDQ)和父母版 5 至 15 问卷。

结果

与足月出生组中 88 名具有正常神经功能和 2 名简单 MND 的儿童相比,出生时患有 CP 的 51 名早产儿中有正常神经功能,23 名有单纯 MND,6 名有复杂 MND(p<0.001)。在早产儿组中,具有正常神经功能和 MND 的儿童在 MABC-2 评估的运动功能(p<0.001)、WISC-IV 评估的一般认知能力(p=0.005)以及父母报告的 SDQ 整体行为问题和同伴问题(p=0.021 和 p=0.003)方面存在显著差异。SDQ 教师报告的整体行为和多动问题在具有正常和简单 MND 的儿童之间存在显著差异(p=0.036 和 p=0.019)。

结论

没有 CP 的极早产儿出生时存在 MND 风险,且 MND 与运动功能、认知能力和行为有关。

本文的贡献

极早产儿出生存在轻度神经功能障碍(MND)的风险。极早产儿出生的 MND 与运动功能受损和认知能力下降以及行为问题有关。男性性别与极早产儿的 MND 有关。

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