Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.
Premature Infant Follow-Up Program, Royal Women's Hospital, Melbourne, Australia.
J Dev Behav Pediatr. 2019 Apr;40(3):200-207. doi: 10.1097/DBP.0000000000000646.
To examine whether difficulties in emotional, attention, and peer or social functioning (a proposed "preterm behavioral phenotype") co-occur within individual children born extremely preterm (EP; <28 weeks of gestation) and/or extremely low birth weight (ELBW; <1,000 g) and whether different behavioral profiles are related to cognitive and academic outcomes.
Population-based cohort of all EP/ELBW survivors born in the state of Victoria, Australia, in 2005, and contemporaneous matched controls were recruited at birth. At age 7 to 8 years, parents of 181 EP/ELBW and 185 control children rated their children's behavior on the Strengths and Difficulties Questionnaire problem scales (emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems). Latent profile analysis was used to explore patterns of behavior within individual children.
Four behavioral profiles were identified: (1) minimal difficulties in all domains; (2) a profile consistent with the preterm behavioral phenotype; (3) elevations in all domains except peer problems; and (4) marked global elevations in all domains. Most preterm children (55%) had a profile of minimal difficulties. Relative to their risk of being in the minimal difficulties group, EP/ELBW children were overrepresented in the preterm behavioral phenotype (20% vs. 12% controls) and the globally elevated symptom groups (8% vs. 3%). Accounting for birth group and demographic variables, profiles with higher levels of behavior symptoms were associated with poorer cognitive and academic performance.
Although more EP/ELBW children exhibited the proposed preterm behavioral phenotype than controls, it occurred in only 20% of EP/ELBW children. Greater behavior symptoms were associated with poorer cognitive and academic outcomes.
研究在极早早产（<28 周妊娠）和/或极低出生体重（<1000 克）出生的个体儿童中，情绪、注意力、同伴或社交功能（一种提出的“早产行为表型”）困难是否共同发生，以及不同的行为特征是否与认知和学业结果相关。
本研究为基于人群的队列研究，纳入了 2005 年在澳大利亚维多利亚州出生的所有极早早产/极低出生体重幸存者及其同期匹配的对照组。在 7 至 8 岁时，181 名极早早产/极低出生体重儿和 185 名对照组儿童的父母使用长处与困难问卷（Strengths and Difficulties Questionnaire，SDQ）对其儿童的行为进行评分，包括问题量表（情绪症状、品行问题、多动/注意力不集中和同伴问题）。采用潜在剖面分析探索个体儿童的行为模式。
共识别出 4 种行为特征：（1）所有领域均存在轻微困难；（2）符合早产行为表型的特征；（3）除同伴问题外，所有领域均升高；（4）所有领域均显著升高。大多数早产儿童（55%）表现出轻微困难的特征。与处于轻微困难组的风险相比，极早早产/极低出生体重儿在早产行为表型（20%比对照组 12%）和全身症状升高组（8%比对照组 3%）中过度出现。在考虑出生组和人口统计学变量后，具有更高水平行为症状的特征与较差的认知和学业成绩相关。
尽管与对照组相比，更多的极早早产/极低出生体重儿表现出了所提出的早产行为表型，但仅在 20%的极早早产/极低出生体重儿中出现。更严重的行为症状与较差的认知和学业结果相关。
