印度北部低出生体重儿认知、运动和语言评分的决定因素。
Factors determining cognitive, motor and language scores in low birth weight infants from North India.
机构信息
Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
出版信息
PLoS One. 2021 May 12;16(5):e0251387. doi: 10.1371/journal.pone.0251387. eCollection 2021.
BACKGROUND
Children born with low birth weight (LBW) tend to have lower neurodevelopmental scores compared to term normal birth weight children. It is important to determine factors that influence neurodevelopment in these low birth weight children especially in the first 2-3 years of life that represents a period of substantial brain development.
METHODS
This secondary data analysis was conducted using data from LBW infants enrolled soon after birth in an individually randomized controlled trial (RCT) and followed up till end of 1st year. Neurodevelopmental assessment was done at 12 months of corrected age by trained psychologists using Bayley Scales of Infant and Toddler Development 3rd edition (Bayley-III). Factors influencing cognitive, motor and language scores were determined using multivariable linear regression model.
RESULTS
Linear growth (i.e., length for age z score, LAZ) [cognitive: Standardized ẞ-coefficient = 2.19, 95% CI; 1.29, 3.10; motor: 2.41, 95% CI; 1.59, 3.23; language: 1.37, 95% CI; 0.70, 2.04], stimulation at home [cognitive: 0.21, 95% CI; 0.15, 0.27; motor: 0.12, 95% CI; 0.07, 0.17; language: 0.21, 95% CI; 0.16, 0.25] and number of diarrhoeal episodes [cognitive: -2.87, 95% CI; -4.34, -1.39; motor: -2.62, 95% CI; -3.93, -1.29; language: -2.25, 95% CI; -3.32, -1.17] influenced the composite scores in all three domains i.e., cognitive, language and motor. While increase in LAZ score and stimulation led to increase in composite scores; an increase in number of diarrhoeal episodes was associated with decrease in scores. Weight for height z scores (WHZ) were associated with motor and language but not with cognitive scores. Additionally, a negative association of birth order with cognitive and language scores was noted.
CONCLUSIONS
The findings indicate the possible importance of promoting nutrition and preventing diarrhoea as well as ensuring optimal stimulation and nurturance at home for enhancing child development in LBW infants.
背景
与足月正常出生体重的儿童相比，出生体重较低（LBW）的儿童往往具有较低的神经发育评分。确定影响这些低出生体重儿童神经发育的因素非常重要，尤其是在生命的头 2-3 年，这是大脑发育的重要时期。
方法
本二次数据分析使用了在个体随机对照试验（RCT）后不久即出生的 LBW 婴儿的数据，并在 1 岁时进行了随访。通过受过培训的心理学家在 12 个月的校正年龄时使用贝利婴幼儿发育量表第三版（Bayley-III）进行神经发育评估。使用多变量线性回归模型确定影响认知、运动和语言评分的因素。
结果
线性生长（即年龄身长 z 评分，LAZ）[认知：标准化ẞ系数=2.19，95%置信区间；1.29，3.10；运动：2.41，95%置信区间；1.59，3.23；语言：1.37，95%置信区间；0.70，2.04]、家庭刺激[认知：0.21，95%置信区间；0.15，0.27；运动：0.12，95%置信区间；0.07，0.17；语言：0.21，95%置信区间；0.16，0.25]和腹泻发作次数[认知：-2.87，95%置信区间；-4.34，-1.39；运动：-2.62，95%置信区间；-3.93，-1.29；语言：-2.25，95%置信区间；-3.32，-1.17]影响所有三个领域（认知、语言和运动）的综合评分。虽然 LAZ 评分的增加和刺激的增加导致了综合评分的增加，但腹泻发作次数的增加与评分的降低有关。身高体重 z 评分（WHZ）与运动和语言有关，但与认知评分无关。此外，还注意到出生顺序与认知和语言评分呈负相关。
结论
研究结果表明，促进营养、预防腹泻以及确保家庭中最佳刺激和养育可能对提高 LBW 婴儿的儿童发育非常重要。
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