Wallace Erin R, Ola Cindy, Leroux Brian G, Speltz Matthew L, Collett Brent R
Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.
Department of Biostatistics, University of Washington School of Dentistry, Seattle, Washington, USA.
Paediatr Child Health. 2020 Apr 17;26(3):e132-e137. doi: 10.1093/pch/pxaa012. eCollection 2021 Jun.
Children with positional plagiocephaly and/or brachycephaly (PPB) are at risk of early developmental delay, but little is known about early life factors associated with school-age neurodevelopment. This study examined associations of demographic characteristics, prenatal risk factors and early neurodevelopment assessment with school-age IQ, academic performance, and motor development in children with PPB.
The study sample consisted of 235 school-age children with PPB followed since infancy. Outcome measures included IQ using the Differential Ability Scales-Second Edition, academic achievement as measured by the Wechsler Individualized Achievement Tests-Third Edition), and motor function using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition. Linear regression was used to examine the incremental improvement of model fit of demographics, prenatal and early life characteristics, severity of PPB, and neurodevelopment at ages 7, 18, and 36 months as measured by the Bayley-3 on school-age scores.
Mean age at school-age assessment was 9.0 years. Adjusted r for demographic, prenatal, and early life risk factors ranged from 0.10 to 0.22. Addition of PPB severity and Bayley-3 measures at ages 7 and 18 months did not meaningfully change model fit. Adjusted r after inclusion of Bayley-3 at 36 months ranged from 0.35 to 0.41.
This study suggests that PPB severity and very early life neurodevelopment have little association with school-age neurodevelopment above and beyond demographic and early life risk factors. However, preschool-age neurodevelopmental assessment may still be useful in identifying children with PPB at risk for delay and who may benefit from early intervention.
患有体位性斜头畸形和/或短头畸形(PPB)的儿童有早期发育迟缓的风险,但对于与学龄期神经发育相关的早期生活因素知之甚少。本研究调查了PPB儿童的人口统计学特征、产前危险因素和早期神经发育评估与学龄期智商、学业成绩和运动发育之间的关联。
研究样本包括235名自婴儿期起就被跟踪研究的学龄期PPB儿童。结果测量指标包括使用《差异能力量表第二版》测得的智商、使用《韦氏个别成就测验第三版》测得的学业成绩,以及使用《布鲁宁克斯-奥西瑞斯基运动熟练程度测验第二版》测得的运动功能。采用线性回归分析来检验人口统计学、产前和早期生活特征、PPB严重程度以及7个月、18个月和36个月时通过贝利婴幼儿发展量表第三版(Bayley-3)测量的神经发育情况对学龄期分数模型拟合度的增量改善。
学龄期评估的平均年龄为9.0岁。人口统计学、产前和早期生活危险因素的调整r值范围为0.10至0.22。加入PPB严重程度以及7个月和18个月时的贝利婴幼儿发展量表测量结果后,模型拟合度没有显著变化。纳入36个月时的贝利婴幼儿发展量表测量结果后的调整r值范围为0.35至0.41。
本研究表明,除了人口统计学和早期生活危险因素外,PPB严重程度和极早期生活神经发育与学龄期神经发育的关联不大。然而,学龄前神经发育评估对于识别有发育迟缓风险的PPB儿童以及可能从早期干预中受益的儿童可能仍然有用。