Jin Ju Hyun, Yoon Shin Won, Song Jungeun, Kim Seong Woo, Chung Hee Jung
Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Clin Exp Pediatr. 2020 Jun;63(6):219-225. doi: 10.3345/kjp.2019.00647. Epub 2019 Sep 25.
There is increasing concern that moderate preterm (32-33 weeks' gestation) and late preterm (34-36 weeks' gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance.
We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at school age in moderate to late preterm infants.
Children aged 7-10 years who were born at 32+0 to 36+6 weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires.
A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes.
Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.
越来越多的人担心中度早产（妊娠32 - 33周）和晚期早产（妊娠34 - 36周）可能与影响学业成绩不佳的轻微神经发育问题有关。
我们探讨了中度至晚期早产婴儿在学龄期的认知功能、认知视觉功能、执行功能和行为问题。
纳入2006年8月至2011年7月在韩国国民健康保险公团一山医院出生于妊娠32 + 0至36 + 6周并入住新生儿重症监护病房的7 - 10岁儿童。我们排除了患有严重神经损伤、先天性畸形或染色体异常的儿童。神经心理学评估包括5项神经心理学测试和3份问卷。
共有37名儿童（平均年龄9.1±1.2岁）参与。出生时的平均孕周为34.6±7.5周，平均出生体重为2229.2±472.8克。平均全量表智商为92.89±11.90；24.3%的儿童得分在70至85之间（边缘智力功能）。65%的儿童在注意力缺陷多动障碍诊断系统的至少一项变量上得分异常。执行商数和记忆商数低于边缘功能的比例分别为32.4%和24.3%。在儿童行为清单上，有13.5%的儿童存在边缘或临床相关的内化问题。围产期因素或社会经济地位与认知、视觉感知、执行功能或行为结果之间没有显著关联。
中度至晚期早产婴儿在学龄早期有发展为边缘智力功能和注意力问题的风险。对于学业成绩重要的认知和执行功能必须在中度至晚期早产婴儿中仔细监测并持续随访。
