Cha Jong Ho, Ahn Ja-Hye, Kim Yun Jin, Lee Bong Gun, Kim Johanna Inhyang, Park Hyun-Kyung, Kim Bung-Nyun, Lee Hyun Ju
Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea.
Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul 04763, Korea.
J Clin Med. 2022 Apr 28;11(9):2476. doi: 10.3390/jcm11092476.
Neurodevelopmental disorder (NDD) in preterm infants has become of great interest. We aimed to investigate the impact of preterm birth on the proportion of NDD using nationwide data provided by the Korean National Health Insurance Service. We included 4894 extremely preterm or extremely low-birth-weight (EP/ELBW; <28 weeks of gestation or birth weight < 1000 g) infants, 70,583 other preterm or low-birth-weight (OP/LBW; 28−36 weeks of gestation or birth weight < 2500 g) infants, and 264,057 full-term infants born between 2008 and 2015. We observed their neurodevelopment until 6 years of age or until the year 2019, whichever occurred first. Diagnoses of NDDs were based on the World Health Organization’s International Classification of Diseases 10th revision. An association between preterm birth and NDD was assessed using a multivariable logistic regression model. There was a stepwise increase in the risk of overall NDD with increasing degree of prematurity, from OP/LBW (adjusted odds ratio 4.46; 95% confidence interval 4.34−4.58), to EP/ELBW (16.15; 15.21−17.15). The EP/ELBW group was strongly associated with developmental delay (21.47; 20.05−22.99), cerebral palsy (88.11; 79.89−97.19), and autism spectrum disorder (11.64; 10.37−13.06). Preterm birth considerably increased the risk of NDD by the degree of prematurity.
早产儿的神经发育障碍（NDD）已引起了极大关注。我们旨在利用韩国国民健康保险服务提供的全国性数据，调查早产对NDD比例的影响。我们纳入了4894名极早产儿或极低出生体重儿（EP/ELBW；孕周<28周或出生体重<1000g）、70583名其他早产儿或低出生体重儿（OP/LBW；孕周28 - 36周或出生体重<2500g）以及2008年至2015年出生的264057名足月儿。我们观察他们的神经发育情况直至6岁或2019年，以先到者为准。NDD的诊断基于世界卫生组织《国际疾病分类》第10次修订版。使用多变量逻辑回归模型评估早产与NDD之间的关联。随着早产程度的增加，总体NDD的风险呈逐步上升趋势，从OP/LBW组（调整后的优势比为4.46；95%置信区间4.34 - 4.58）到EP/ELBW组（16.15；15.21 - 17.15）。EP/ELBW组与发育迟缓（21.47；20.05 - 22.99）、脑瘫（88.11；79.89 - 97.19）和自闭症谱系障碍（11.64；10.37 - 13.06）密切相关。早产会根据早产程度显著增加患NDD的风险。
