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唇腭裂患儿的神经发育轨迹:基于日本环境与儿童研究的纵向研究

Neurodevelopmental trajectories in children with cleft lip and palate: A longitudinal study based on the Japan Environment and Children's Study.

作者信息

Tsuchiya Shinobu, Tsuchiya Masahiro, Momma Haruki, Aida Jun, Nagatomi Ryoichi, Yaegashi Nobuo, Arima Takahiro, Igarashi Kaoru

机构信息

Department of Orthodontics and Speech Therapy for Craniofacial Anomalies, Tohoku University Hospital, Sendai, Japan.

Department of Nursing, Tohoku Fukushi University, Sendai, Japan.

出版信息

Eur J Oral Sci. 2022 Apr;130(2):e12857. doi: 10.1111/eos.12857. Epub 2022 Feb 15.

Abstract

Cleft lip and/or palate (CL/P), the most prevalent congenital anomaly, is understood to negatively affect a wide range of child development. Since the concept remains controversial, because most published work is from cross-sectional studies, we examined the neurodevelopmental trajectories in participants with CL/P through a longitudinal comparison with the general population during early childhood using data from a nationwide birth cohort study in Japan. The linear mixed models for each domain of the Ages and Stages Questionnaire, third edition (ASQ-3), were used to detect differences in standardised mean scores between groups. The ASQ-3 is a general neurodevelopmental screening tool comprising communication, gross motor, fine motor, problem-solving, and personal-social domains. Participants' neurodevelopment was determined semi-annually from 6 to 36 months of age. The trajectories of standardised mean scores in each domain showed several significant differences between the control and CL/P groups, with the maximum difference at 24 months of age in the communication domain. Indeed, CL/P was associated with significantly lower scores in the communication (coefficient: -3.31, 95% CI: -5.09 to -1.14), problem-solving (coefficient: -3.13, 95% CI: -5.07 to -1.18), and personal-social domains (coefficient: -1.99, 95% CI: -3.87 to -0.11). Trajectories of ASQ-3 scores suggest neurodevelopmental delays in children with CL/P.

摘要

唇腭裂(CL/P)是最常见的先天性异常,据了解会对儿童的广泛发育产生负面影响。由于这一概念仍存在争议,因为大多数已发表的研究都是横断面研究,我们利用日本一项全国性出生队列研究的数据,通过与一般人群在幼儿期的纵向比较,研究了CL/P患者的神经发育轨迹。使用《年龄与阶段问卷》第三版(ASQ-3)各领域的线性混合模型来检测两组之间标准化平均得分的差异。ASQ-3是一种一般的神经发育筛查工具,包括沟通、大运动、精细运动、解决问题和个人社交领域。从6个月至36个月龄,每半年对参与者的神经发育情况进行一次评估。各领域标准化平均得分的轨迹显示,对照组和CL/P组之间存在若干显著差异,在沟通领域,24个月龄时差异最大。事实上,CL/P与沟通领域(系数:-3.31,95%置信区间:-5.09至-1.14)、解决问题领域(系数:-3.13,95%置信区间:-5.07至-1.18)和个人社交领域(系数:-1.99,95%置信区间:-3.87至-0.11)的得分显著较低有关。ASQ-3得分轨迹表明CL/P儿童存在神经发育延迟。

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