Department of Psychology and Division of Mental Health & Wellbeing, University of Warwick, Coventry, United Kingdom.
Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
J Dev Behav Pediatr. 2020 Aug;41(6):461-469. doi: 10.1097/DBP.0000000000000806.
To determine whether the attention problems in adults born very preterm/very low birth weight (VP/VLBW; <32 weeks' gestation/<1500 g) or extremely preterm (EP; <26 weeks' gestation) are associated with specific executive or general cognitive deficits.
Cohorts of VP/VLBW (the Bavarian Longitudinal Study [BLS]) and EP (the EPICure Study) participants were followed from birth to early adulthood, each also following a respective control group. Adult attention deficit hyperactivity disorder (ADHD) symptoms were assessed via self-report in both cohorts and additionally by parent report in the BLS. Participants in both cohorts also had their attention span rated by trained observers. Performed separately in each cohort, hierarchical regression analyses were used to assess whether the association between preterm birth status and attention problems remained after accounting for executive functioning (inhibitory control and working memory) in adulthood, childhood intelligence score (IQ), or sex.
In the discovery cohort of the BLS, significant differences were found between VP/VLBW adults and controls for parent-rated inattention (p < 0.001). However, for self-reported measures of ADHD, no significant differences were found in the BLS or in the EPICure replication cohort. In both cohorts, observer-rated attention spans were lower for VP/VLBW and EP participants in comparison to their respective control groups (p < 0.001). In final models for the BLS, inhibitory control and childhood IQ were significantly associated with parent-rated inattention symptoms (p < 0.006), whereas working memory and childhood IQ were significantly associated with observer-rated attention span (p < 0.001). The effect of childhood IQ on observer-rated attention span was replicated in EPICure.
VP/VLBW and EP adults are at increased risk of observer-rated attention problems. These problems were predominantly associated with poorer general cognitive ability in early childhood and somewhat with adult executive functioning.
确定极早产儿/极低出生体重儿（<32 周/ <1500 克）或超早产儿（<26 周）出生的成年人的注意力问题是否与特定的执行功能或一般认知缺陷有关。
对极早产儿/极低出生体重儿（巴伐利亚纵向研究 [BLS]）和超早产儿（EPICure 研究）参与者的队列进行了从出生到成年早期的随访，每个队列也都有相应的对照组。两个队列都通过自我报告评估了成人注意力缺陷多动障碍（ADHD）症状，BLS 队列还通过父母报告进行了评估。两个队列的参与者的注意力跨度也由经过培训的观察者进行了评分。在每个队列中分别进行的分层回归分析用于评估在考虑到成年后的执行功能（抑制控制和工作记忆）、儿童智力评分（智商）或性别后，早产儿出生状态与注意力问题之间的关联是否仍然存在。
在 BLS 的发现队列中，VP/VLBW 成人与对照组在父母评定的注意力不集中方面存在显著差异（p < 0.001）。然而，在 BLS 或 EPICure 复制队列中，自我报告的 ADHD 测量没有发现显著差异。在两个队列中，与各自的对照组相比，VP/VLBW 和 EP 参与者的观察者评定注意力跨度较低（p < 0.001）。在 BLS 的最终模型中，抑制控制和儿童智商与父母评定的注意力不集中症状显著相关（p < 0.006），而工作记忆和儿童智商与观察者评定的注意力跨度显著相关（p < 0.001）。EPICure 中复制了儿童智商对观察者评定注意力跨度的影响。
VP/VLBW 和 EP 成人患观察者评定的注意力问题的风险增加。这些问题主要与幼儿期较差的一般认知能力有关，在某种程度上与成人的执行功能有关。
