Department of Child Health, University of Missouri Medical School, Columbia, MO, USA.
Department of Communication Science and Disorders, University of Missouri, Columbia, MO, USA.
Early Hum Dev. 2019 Sep;136:60-69. doi: 10.1016/j.earlhumdev.2019.05.006. Epub 2019 Aug 1.
In 1989-1991, a population-based cohort of every Missouri birth weighing < 1500 g was identified over a 16-month period. Infants born moderately low birth weight (MLBW, 1500-2499 g) and normal birth weight (NBW, ≥ 2500 g), were matched to < 1500 g infants by delivery date, race, maternal age, and residence.
To compare outcomes of extremely low birth weight (ELBW, < 1000 g), very low birth weight (VLBW, 1000-1499 g), and MLBW, to NBW infants at age 10.
A population-based cohort and matched case-control study OUTCOME MEASURES: A Child Health and Development Questionnaire developed for this study collected social, medical, educational and special services history. The Conners' Parent Rating Scale-Revised was also completed by parents/caregivers.
As birth weight declined, the prevalence of adverse outcomes increased. Children in all LBW groups were more likely than NBW children to have problems in speech and language, vision, fine and gross motor tasks, illnesses, attention, school performance, and increased requirements for therapy and accommodation. Repetition of a grade was three times higher for MLBW children and over three times higher for the other LBW groups.
In this statewide population-based study, controlling for child's sex, mother's age, race, residence, education, marital status, Medicaid assistance, and smoking or alcohol use during pregnancy, failed to eliminate the strong effect of decreasing birth weight. Problems were most frequent in ELBW, however, VLBW and MLBW also had many significantly greater problems than NBW children. All LBW groups of children experienced greater adverse health and developmental outcomes resulting in significant habilitation and educational challenges.
1989 年至 1991 年，在 16 个月的时间内，确定了密苏里州每一个出生体重低于 1500 克的人群为基础的队列。出生时体重适中偏低（MLBW，1500-2499 克）和正常出生体重（NBW，≥2500 克）的婴儿，根据分娩日期、种族、母亲年龄和居住地与体重低于 1500 克的婴儿相匹配。
比较极低出生体重（ELBW，<1000 克）、极低出生体重（VLBW，1000-1499 克）和 MLBW 与 NBW 婴儿在 10 岁时的结局。
一项基于人群的队列和匹配病例对照研究
为这项研究开发的儿童健康和发展问卷收集了社会、医疗、教育和特殊服务的历史。家长/照顾者也完成了康纳父母评定量表修订版。
随着出生体重的下降，不良结局的发生率也随之增加。所有 LBW 组的儿童比 NBW 儿童更有可能在言语和语言、视力、精细和粗大运动任务、疾病、注意力、学校表现以及对治疗和适应的需求增加方面出现问题。MLBW 儿童重读一年的比例是正常体重儿童的三倍，其他 LBW 组的比例则超过三倍。
在这项全州范围内的基于人群的研究中，控制了儿童的性别、母亲的年龄、种族、居住地、教育程度、婚姻状况、医疗补助、以及怀孕期间吸烟或饮酒的情况，仍然无法消除出生体重下降的强烈影响。ELBW 儿童的问题最为频繁，但 VLBW 和 MLBW 儿童的问题也比 NBW 儿童多得多。所有 LBW 组的儿童都经历了更多的不良健康和发育结果，导致了重大的康复和教育挑战。
