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利用韩国国家健康保险服务理赔数据评估出生体重与神经发育障碍之间的关系。

Association between birth weight and neurodevelopmental disorders assessed using the Korean National Health Insurance Service claims data.

机构信息

Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea.

Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.

出版信息

Sci Rep. 2022 Feb 8;12(1):2080. doi: 10.1038/s41598-022-06094-x.

Abstract

The risk of neurodevelopmental disorders in low birth weight (LBW) infants has gained recognition but remains debatable. We investigated the risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in school-aged children according to their birth weight. We conducted a retrospective cohort study using the Korean National Health Insurance claims data of 2,143,652 children who were born between 2008 and 2012. Gestational age of infants was not available; thus, outcomes were not adjusted with it. Not only infants with birth weights of < 1.5 kg, but also 2.0-2.4 kg and 1.5-1.9 kg were associated with having ADHD; odds ratio (OR), 1.41 (95% confidence interval [CI] 1.33-1.50), and 1.49 (95% CI 1.33-1.66), respectively. The OR in infants with birth weights of 2.0-2.4 kg and 1.5-1.9 kg was 1.91 (95% CI 1.79-2.05) and 3.25 (95% CI 2.95-3.59), respectively, indicating increased odds of having ASD. Subgroup analysis for children without perinatal diseases showed similar results. In this national cohort, infants with birth weights of < 2.5 kg were associated with ADHD and ASD, regardless of perinatal history. Children born with LBW need detailed clinical follow-up.

摘要

低出生体重 (LBW) 婴儿发生神经发育障碍的风险已得到认可,但仍存在争议。我们根据出生体重调查了学龄儿童注意缺陷多动障碍 (ADHD) 和自闭症谱系障碍 (ASD) 的发病风险。我们使用韩国国家健康保险索赔数据进行了一项回顾性队列研究,该数据涵盖了 2008 年至 2012 年期间出生的 2143652 名儿童。由于无法获得婴儿的胎龄,因此未对其进行调整。不仅出生体重 <1.5kg 的婴儿,2.0-2.4kg 和 1.5-1.9kg 的婴儿也与 ADHD 相关;优势比(OR)分别为 1.41(95%置信区间 [CI] 1.33-1.50)和 1.49(95% CI 1.33-1.66)。出生体重为 2.0-2.4kg 和 1.5-1.9kg 的婴儿的 OR 分别为 1.91(95% CI 1.79-2.05)和 3.25(95% CI 2.95-3.59),表明 ASD 的发病风险增加。对于没有围产期疾病的儿童进行的亚组分析得出了类似的结果。在这项全国性队列研究中,无论是否存在围产期病史,出生体重 <2.5kg 的婴儿均与 ADHD 和 ASD 相关。出生体重较低的儿童需要进行详细的临床随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb8b/8827104/c6ffe1e5f6a4/41598_2022_6094_Fig1_HTML.jpg

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