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极早产儿学龄期儿童生活质量的特定认知相关性,且无主要神经发育障碍。

Specific cognitive correlates of the quality of life of extremely preterm school-aged children without major neurodevelopmental disability.

机构信息

Department of Neonatology, North Hospital, APHM University Hospital, Chemin des Bourrely, 13015, Marseille, France.

EA3279, Self-Perceived Health Assessment Research Unit, Faculty of Medicine, Marseille, 13385, France.

出版信息

Pediatr Res. 2020 Oct;88(4):642-652. doi: 10.1038/s41390-020-0795-8. Epub 2020 Feb 12.

Abstract

BACKGROUND

We examined how specific cognitive behavioral impairments impacted quality of life (QoL) within a large multicenter cohort of 7-10 year olds surviving extremely preterm (EPT) without major neurodevelopmental disability.

METHODS

Between 7 and 10 years of age, two generic, self-proxy, and parental evaluations were obtained. QoL measurement questionnaires (Kidscreen-10/VSPA (Vécu et Santé Perçue de l'Enfant et de l'Adolescent)) were used and compared to a reference population. The general and specific cognitive functions, such as executive functions, behavior and anxiety, and clinical neurologic examination, were also assessed.

RESULTS

We analyzed 211 school-aged EPT children. The mean gestational age was 26.2 (±0.8) weeks, birth weight was 879 g (±181) and the mean age was 8.4 years (±0.87). Children with a Full-Scale Index Quotient ≥89, who were considered as normal, had a lower QoL. Specific cognitive impairments: comprehensive language delay, visuo-spatial integration defect, and dysexecutive disorders) were the QoL correlates in the domains of school performance and body image.

CONCLUSIONS

School and health care professionals need to increase their focus on EPT children's lower so as to recognize the preterm behavioral/cognitive phenotype and their potential need for supportive measures. Research on preventive interventions is warranted to investigate if these long-term effects of an EPT birth can be attenuated in neonatal period and after.

摘要

背景

我们研究了在一个大型多中心队列中,7-10 岁的极早产儿(EPT)在没有重大神经发育障碍的情况下,特定的认知行为障碍如何影响生活质量(QoL)。

方法

在 7 至 10 岁之间,我们获得了两个通用的、自我代理的和父母代理的评估。使用生活质量测量问卷(Kidscreen-10/VSPA(儿童和青少年的体验和感知健康))并与参考人群进行比较。还评估了一般和特定的认知功能,如执行功能、行为和焦虑以及临床神经检查。

结果

我们分析了 211 名学龄期 EPT 儿童。平均胎龄为 26.2(±0.8)周,出生体重为 879g(±181),平均年龄为 8.4 岁(±0.87)。全量表指数≥89 的儿童被认为是正常的,他们的生活质量较低。特定的认知障碍:全面语言延迟、视空间整合缺陷和执行功能障碍)是与学校表现和身体形象相关的 QoL 相关因素。

结论

学校和卫生保健专业人员需要更加关注 EPT 儿童的生活质量,以识别早产儿的行为/认知表型及其潜在的支持措施需求。需要进行预防干预的研究,以调查 EPT 出生的这些长期影响是否可以在新生儿期和之后减轻。

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