Institute for Global Health Policy Research, Bureau of International Health, National Center for Global Health and Medicine, Tokyo, Japan
Department of Epidemiology and Public Health, University College London, London, UK.
Arch Dis Child. 2021 Nov;106(11):1075-1080. doi: 10.1136/archdischild-2020-321317. Epub 2021 Mar 2.
To examine if gestational age groups predict the development of social competence difficulties (SCDs) from childhood into mid-adolescence and to assess the mediation by maternal psychological distress during infancy on these trajectories.
Nationally representative population-based birth cohort (UK Millennium Cohort Study).
15 821 children born in 2000-2002.
SCDs (derived from peer and prosocial subscales of Strengths and Difficulties Questionnaire) were assessed by parent report when the participants were aged 3, 5, 7, 11 and 14 years. Maternal psychological distress was self-rated using Rutter Malaise Inventory when the children were 9 months of age. Data were modelled using latent growth curve analysis.
Developmental trajectories of SCDs were U-shaped in all groups. Very preterm (VP) children (<32 weeks, n=173) showed pronounced difficulties throughout, with the coefficient difference from the full term at age 14 being 0.94 (95% CI 0.23 to 1.66, equivalent to 0.32 SD of the population average SCDs). Moderate-to-late preterm children (32-36 weeks, n=1130) and early-term children (37-38 weeks, n=3232) showed greater difficulties compared with the full-term peers around age 7 years, which resolved by age 14 years (b=0.20, 95% CI -0.05 to 0.44; b=0.03, 95% CI -0.12 to 0.17, respectively). Maternal psychological distress during infancy mediated 20% of the aforementioned association at age 14 years for the VP.
There was a dose-response association between gestational age and the trajectories of SCDs. Monitoring and providing support on social development throughout childhood and adolescence and treating early maternal psychological distress may help children who were born earlier than ideal, particularly those born VP.
探讨胎龄分组是否能预测儿童期至青春期中期社会能力困难（SCD）的发展，并评估婴儿期母亲心理困扰在此轨迹中的中介作用。
全国代表性的基于人群的出生队列（英国千禧年队列研究）。
2000-2002 年出生的 15821 名儿童。
SCD（源自同伴和亲社会困难问卷的子量表）由参与者 3、5、7、11 和 14 岁时的父母报告评估。儿童 9 个月大时，母亲使用 Rutter 不适量表进行自我评估。使用潜在增长曲线分析对数据进行建模。
在所有组别中，SCD 的发展轨迹均呈 U 形。非常早产儿（VP；<32 周，n=173）整个过程中表现出明显的困难，与 14 岁时足月儿童的系数差异为 0.94（95%CI 0.23 至 1.66，相当于人群平均 SCD 的 0.32 个标准差）。中晚期早产儿（32-36 周，n=1130）和早期早产儿（37-38 周，n=3232）与足月同龄人相比，在 7 岁左右表现出更大的困难，到 14 岁时困难得到解决（b=0.20，95%CI -0.05 至 0.44；b=0.03，95%CI -0.12 至 0.17）。婴儿期母亲心理困扰解释了 VP 组 14 岁时上述关联的 20%。
胎龄与 SCD 轨迹之间存在剂量反应关系。在整个儿童期和青春期监测和提供社会发展方面的支持，并治疗早期母亲心理困扰，可能有助于帮助那些出生时间早于理想时间的儿童，尤其是那些非常早产儿。
