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极早产儿十岁时超重和肥胖的神经认知与健康相关性。

Neurocognitive and Health Correlates of Overweight and Obesity among Ten-Year-Old Children Born Extremely Preterm.

机构信息

Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, NC.

Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, NC.

出版信息

J Pediatr. 2018 Sep;200:84-90.e4. doi: 10.1016/j.jpeds.2018.05.011. Epub 2018 Jun 28.

Abstract

OBJECTIVE

To assess the relationship between overweight (body mass index [BMI] percentile ≥85 and <95) and obesity (BMI ≥95 percentile) and developmental and health outcomes at 10 years of age in a cohort of individuals born extremely preterm.

STUDY DESIGN

This was an observational cohort study of children born extremely preterm and then assessed at age 10 years for neurocognitive function and parent-reported behavior and health outcomes. Participants included 871 children aged 10 years. To describe the strength of association between overweight or obesity and outcomes, we used logistic regression models adjusting for confounders. Neurocognitive function, academic achievement, parent-reported health outcome surveys, and height and weight were measured.

RESULTS

BMI category at 10 years of age was not associated with differences in intelligence, language, or academic achievement. Parents of children with obesity were more likely to report their child had asthma (OR 2.2; 95% CI 1.4-3.5), fair/poor general health (OR 3.2; 95% CI 1.4-7.5), and decreased physical function (OR 1.7; 95% CI 1.1-2.9) but less likely to have physician diagnosed attention-deficit/hyperactivity disorder (OR 0.5; 95% CI 0.3-0.97) or an individualized education plan (OR 0.6; 95% CI 0.4-0.99).

CONCLUSION

Among children born extremely preterm, an elevated BMI, compared with normal or low BMI, is not associated with a difference in neurocognitive function. However, asthma, fair/poor general health, and decreased physical function were more prevalent among study participants with obesity, and attention-deficit/hyperactivity disorder and individualized education plan were less prevalent.

摘要

目的

评估在极低出生体重儿队列中,超重(体重指数[BMI]百分位≥85 且<95)和肥胖(BMI≥95 百分位)与 10 岁时发育和健康结果之间的关系。

研究设计

这是一项对极低出生体重儿进行的观察性队列研究,然后在 10 岁时评估神经认知功能以及父母报告的行为和健康结果。参与者包括 871 名 10 岁的儿童。为了描述超重或肥胖与结局之间的关联强度,我们使用了调整混杂因素的逻辑回归模型。测量了神经认知功能、学业成绩、父母报告的健康结果调查以及身高和体重。

结果

10 岁时的 BMI 类别与智力、语言或学业成绩的差异无关。肥胖儿童的父母更有可能报告他们的孩子患有哮喘(OR 2.2;95%CI 1.4-3.5)、一般健康状况不佳(OR 3.2;95%CI 1.4-7.5)和身体功能下降(OR 1.7;95%CI 1.1-2.9),但不太可能被诊断为注意力缺陷多动障碍(OR 0.5;95%CI 0.3-0.97)或制定个性化教育计划(OR 0.6;95%CI 0.4-0.99)。

结论

在极低出生体重儿中,与正常或低 BMI 相比,升高的 BMI 与神经认知功能的差异无关。然而,肥胖儿童中哮喘、一般健康状况不佳和身体功能下降更为普遍,而注意力缺陷多动障碍和个性化教育计划则较少见。

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