Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Newborn Research, Royal Women's Hospital, Melbourne, Australia; Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia.
J Pediatr. 2018 Nov;202:86-91.e1. doi: 10.1016/j.jpeds.2018.06.036. Epub 2018 Jul 25.
To identify distinct language trajectories of children born very preterm and full term from 2 to 13 years of age and examine predictors for the identified trajectories.
A cohort of 224 children born very preterm and 77 full term controls recruited at birth were followed up at ages 2, 5, 7, and 13 years. The number of distinct language trajectories was examined using latent growth mixture modeling allowing for linear and quadratic time trends. Potential predictors in the neonatal period (eg, birth group, sex, and medical risk) and at 2 years (ie, social risk and use of allied health services) for the language trajectories were tested using multinomial logistic regression.
Five distinct language trajectories were identified across childhood: stable normal (32% of study cohort), resilient development showing catch-up (36%), precocious language skills (7%), stable low (17%), and high-risk (5%) development. The very preterm group was 8 times more likely to have a language trajectory that represented poorer language development compared with full term controls (very preterm, 40%; full term, 6%). Greater social risk and use of allied health services were associated with poorer language development.
Variable language trajectories were observed, with a substantial proportion of children born very preterm exhibiting adverse language development. These findings highlight the need for monitoring language skills in children born very preterm before school entry and across middle childhood.
确定从 2 岁到 13 岁的极早产儿和足月产儿的不同语言轨迹,并研究确定轨迹的预测因素。
本队列研究纳入了 224 名极早产儿和 77 名足月产儿对照,在出生时进行了招募,并在 2、5、7 和 13 岁时进行了随访。使用潜在增长混合建模来检查语言轨迹的不同语言轨迹的数量,允许线性和二次时间趋势。使用多项逻辑回归测试新生儿期(如出生组、性别和医疗风险)和 2 岁时(即社会风险和使用辅助健康服务)的潜在预测因素与语言轨迹的关系。
在整个儿童时期发现了 5 种不同的语言轨迹:稳定正常(研究队列的 32%)、具有追赶能力的弹性发展(36%)、语言技能早熟(7%)、稳定低(17%)和高风险(5%)发展。极早产儿组发生语言轨迹代表较差语言发育的可能性是足月产对照组的 8 倍(极早产儿,40%;足月产,6%)。较高的社会风险和使用辅助健康服务与较差的语言发育相关。
观察到可变的语言轨迹,很大一部分极早产儿的语言发育不良。这些发现强调了在进入学校前和整个儿童中期监测极早产儿语言技能的必要性。