Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
PLoS One. 2019 May 2;14(5):e0216468. doi: 10.1371/journal.pone.0216468. eCollection 2019.
To assess which factors, including maternal, lifestyle, pregnancy- and delivery-related, fetal and neonatal factors adjusted for socio-economic status, are related to emotional and behavioral problems in moderately-late preterm born children (MLPs; gestational age 32.0-35.9 weeks) at 4 years of age. MLPs are at greater risk of emotional and behavioral problems than full-term born children. Especially for MLPs, knowledge about factors that increase or decrease the risk of emotional and behavioral problems is scarce.
We assessed emotional and behavioral problems in 809 MLPs between ages 41 and 49 months from the prospective community-based Longitudinal Preterm Outcome Project (LOLLIPOP), using the parent-reported Child Behavior Checklist (CBCL). We collected potential risk factors from hospital records and parental questionnaires. Univariable and multiple logistic regression analyses were applied.
(Sub)clinical CBCL scores.
Perinatal infection increased the risk of CBCL total problem scores with an OR 2.22 (p<0.01). Perinatal infection, maternal smoking, and male gender increased the risk of CBCL externalizing problem scores with ORs between 1.64 and 2.46 (all p<0.05). Multiple birth decreased the risk of CBCL internalizing problem scores with an OR 0.63 (p<0.05).
Risk factors for behavioral problems in MLPs are male gender, perinatal infection and maternal smoking, the latter two being potentially modifiable. Multiple birth is a protective factor for emotional problems in MLPs. These results suggest potential factors for targeting preventive intervention in MLPs, comprising the large majority of all preterm born children.
评估哪些因素（包括母体、生活方式、妊娠和分娩相关、胎儿和新生儿因素，并调整社会经济状况）与中度晚期早产儿（32.0-35.9 周）在 4 岁时的情绪和行为问题有关。与足月出生的儿童相比，MLP 更容易出现情绪和行为问题。特别是对于 MLP 来说，关于增加或降低情绪和行为问题风险的因素的知识还很缺乏。
我们评估了来自前瞻性社区基础纵向早产儿结局研究（LOLLIPOP）的 809 名年龄在 41 至 49 个月的 MLP 的情绪和行为问题，使用父母报告的儿童行为检查表（CBCL）。我们从医院记录和父母问卷中收集潜在的危险因素。应用单变量和多变量逻辑回归分析。
（亚）临床 CBCL 评分。
围产期感染增加了 CBCL 总分的风险，比值比为 2.22（p<0.01）。围产期感染、母亲吸烟和男性性别增加了 CBCL 外化问题评分的风险，比值比在 1.64 至 2.46 之间（均 p<0.05）。多胎妊娠降低了 CBCL 内化问题评分的风险，比值比为 0.63（p<0.05）。
MLP 行为问题的危险因素是男性性别、围产期感染和母亲吸烟，后两者是潜在可改变的。多胎妊娠是 MLP 情绪问题的保护因素。这些结果表明，针对 MLP 进行预防干预的潜在因素，包括所有早产儿的绝大多数。
