Takeuchi Akihito, Yorifuji Takashi, Hattori Mariko, Tamai Kei, Nakamura Kazue, Nakamura Makoto, Kageyama Misao, Kubo Toshihide, Ogino Tatsuya, Kobayashi Katsuhiro, Doi Hiroyuki
Division of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan.
Brain Dev. 2019 May;41(5):397-405. doi: 10.1016/j.braindev.2018.12.004. Epub 2019 Jan 2.
To examine the relationship between the catch-up growth of preterm, SGA children and their behavioral development.
We analyzed data from a large Japanese, nationwide, population-based, longitudinal survey that started in 2001. We restricted the study participants to preterm children with information on height at 2 years of age (n = 1667). Catch-up growth for SGA infants was defined as achieving a height at 2 years of age above -2.0 standard deviations for chronological age. We then used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the associations of SGA/catch-up status with neurobehavioral development both at 5.5 and 8 years of age, adjusting for potential infant- and parent-related confounding factors.
Twenty-six percent of preterm SGA infants failed to catch up. SGA children without catch-up growth were more likely to be unable to listen without fidgeting (OR 2.51, 95% CI: 1.06-5.93) and unable to focus on one task (OR 2.66, 95% CI: 1.09-6.48) compared with non-SGA children at 5.5 years of age. Furthermore, SGA children without catch-up growth were at significant risk for inattention at 8 years of age.
SGA infants with poor postnatal growth were at risk for attention problems throughout preschool-age to school-age among preterm infants. Early detection and intervention for attention problems among these infants is warranted.
探讨早产小于胎龄儿的追赶生长与其行为发育之间的关系。
我们分析了一项始于2001年的大型日本全国性基于人群的纵向调查数据。我们将研究参与者限制为有2岁时身高信息的早产儿童（n = 1667）。小于胎龄儿的追赶生长定义为2岁时身高高于其实际年龄的-2.0标准差。然后，我们使用逻辑回归来估计小于胎龄儿/追赶生长状态与5.5岁和8岁时神经行为发育之间关联的比值比（OR）和95%置信区间（95%CI），并对潜在的婴儿和父母相关混杂因素进行调整。
26%的早产小于胎龄儿未能实现追赶生长。与非小于胎龄儿相比，未实现追赶生长的小于胎龄儿在5.5岁时更有可能无法安静倾听（OR 2.51，95%CI：1.06 - 5.93）以及无法专注于一项任务（OR 2.66，95%CI：1.09 - 6.48）。此外，未实现追赶生长的小于胎龄儿在8岁时存在注意力不集中的显著风险。
早产小于胎龄儿中出生后生长不良的婴儿在整个学龄前到学龄期存在注意力问题的风险。有必要对这些婴儿的注意力问题进行早期检测和干预。
