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早产儿在学龄前的全球智力和神经心理功能更差:一项荟萃分析。

Worse global intellectual and worse neuropsychological functioning in preterm-born children at preschool age: a meta-analysis.

机构信息

Department of Child and Adult Medical and Surgery Science, University Hospital of Modena and Reggio Emilia, Modena, Italy.

Department of Medical and Surgical Science, University Hospital of Modena and Reggio Emilia, Modena, Italy.

出版信息

Acta Paediatr. 2019 Sep;108(9):1567-1579. doi: 10.1111/apa.14836. Epub 2019 Jul 25.

Abstract

AIM

Preterm births (<32 weeks of gestational age) are associated with cognitive problems that are difficult to diagnose in infancy but potentially detectable at preschool age. This review aimed to evaluate the extent to which total intelligence quotient (IQ) and neuropsychological functions at ages three to five years differ between children born at <32 weeks gestational age or < 1500 g birth weight and children born at term. The secondary aim was to determine whether cognitive performance differs between extremely preterm (EPT)/extremely low birth weight (ELBW) children and very preterm (VPT) or very low birth weight (VLBW) children.

METHODS

PubMed and PsycINFO databases were searched for cohort studies comparing IQ and neuropsychological functions in term-born and preterm-born children born after 1994.

RESULTS

At ages three to five years, preterm-born children, compared with term-born ones, had worse IQ mean score (d = -0.77 [95% confidence interval -0.88 to -0.66]), attention, memory, visuomotor integration skill and executive functions. No differences were found between VPT/VLBW and EPT/ELBW children.

CONCLUSION

Preterm-born children showed poorer IQ and neuropsychological functions compared with term-born subjects already at preschool age. The extent of differences is similar to that detected at a later age.

摘要

目的

早产儿(<32 孕周)与认知问题相关,这些问题在婴儿期难以诊断,但在学龄前可能会被发现。本综述旨在评估<32 孕周或<1500 克出生体重的早产儿与足月儿在 3 至 5 岁时的总智商(IQ)和神经心理学功能的差异程度。次要目的是确定极早产儿(EPT)/极低出生体重(ELBW)儿与非常早产儿(VPT)或极低出生体重(VLBW)儿的认知表现是否存在差异。

方法

检索 1994 年后发表的比较足月产儿和早产儿在 3 至 5 岁时 IQ 和神经心理学功能的队列研究,使用 PubMed 和 PsycINFO 数据库。

结果

与足月儿相比,早产儿在 3 至 5 岁时的平均 IQ 得分更差(d=-0.77[95%置信区间-0.88 至-0.66]),注意力、记忆力、视动整合技能和执行功能也更差。VPT/VLBW 儿与 EPT/ELBW 儿之间无差异。

结论

早产儿在学龄前就已表现出比足月儿更低的 IQ 和神经心理学功能。差异的程度与在后期检测到的相似。

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