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早产儿 10 岁时的 BPD 与其认知发育和生活质量的相关性。

Cognitive Development and Quality of Life Associated With BPD in 10-Year-Olds Born Preterm.

机构信息

Department of Pediatrics, Section of Neonatology, and

Department of Pediatrics, Section of Neonatology, and.

出版信息

Pediatrics. 2018 Jun;141(6). doi: 10.1542/peds.2017-2719. Epub 2018 May 17.

Abstract

OBJECTIVES

To compare neurocognitive, language, executive function, academic achievement, neurologic and behavioral outcomes, and quality of life at age 10 years in children born extremely preterm who developed bronchopulmonary dysplasia (BPD) to children who did not develop BPD.

METHODS

The Extremely Low Gestational Age Newborns study population included 863 children born extremely preterm whose BPD status before discharge was known had an IQ (Differential Ability Scales II [DAS II]) assessment at 10 years. We evaluated the association of BPD with any cognitive (DAS II), executive function (NEuroPSYchological Assessment II), academic achievement (Wechsler Individual Achievement Test-III and Oral and Written Language Scales [OWLS]) as well as social dysfunctions (Social Responsiveness Scale). We used logistic regression models, adjusting for potential confounding factors, to assess the strength of association between the severity of BPD and each outcomes.

RESULTS

Three hundred and seventy-two (43%) children were oxygen-dependent at 36 weeks postconception age, whereas an additional 78 (9%) were also oxygen- and ventilator-dependent. IQ scores 2 or more SDs below the expected mean (ie, scores ≤-2) occurred twice as commonly among children who had BPD as among those who did not. Children with severe BPD consistently had the lowest scores on DAS II, OWLS, Wechsler Individual Achievement Test-III, NEuroPSYchological Assessment II, and Social Responsiveness Scale assessments.

CONCLUSIONS

Among 10-year-old children born extremely preterm, those who had BPD were at increased risk of cognitive, language, and executive dysfunctions; academic achievement limitations; social skill deficits; and low scores on assessments of health-related quality of life.

摘要

目的

比较患有支气管肺发育不良(BPD)和未患有 BPD 的极早产儿在 10 岁时的神经认知、语言、执行功能、学业成绩、神经和行为结果以及生活质量。

方法

极低出生体重儿研究人群包括 863 名极早产儿,他们在出院前的 BPD 状态已知,并且在 10 岁时进行了智商(差异能力量表 II [DAS II])评估。我们评估了 BPD 与任何认知(DAS II)、执行功能(神经心理评估 II [NEuroPSYchological Assessment II])、学业成绩(韦氏个人成就测验-III 和口头和书面语言量表 [OWLS])以及社会功能障碍(社会反应量表)之间的关联。我们使用逻辑回归模型,调整潜在的混杂因素,评估 BPD 严重程度与每个结果之间的关联强度。

结果

372 名(43%)儿童在孕后 36 周时需要吸氧,而另外 78 名(9%)儿童还需要吸氧和呼吸机辅助。智商得分低于预期平均值 2 个或更多标准差(即 得分≤-2)在患有 BPD 的儿童中发生的频率是没有 BPD 的儿童的两倍。患有严重 BPD 的儿童在 DAS II、OWLS、韦氏个人成就测验-III、NEuroPSYchological Assessment II 和社会反应量表评估中始终得分最低。

结论

在 10 岁的极早产儿中,患有 BPD 的儿童发生认知、语言和执行功能障碍、学业成绩受限、社交技能缺陷以及健康相关生活质量评估得分较低的风险增加。

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