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从出生到 28 岁的早产儿极低出生体重个体的多学科和神经影像学研究结果:对挪威前瞻性队列研究的系统评价。

Multidisciplinary and neuroimaging findings in preterm born very low birthweight individuals from birth to 28 years of age: A systematic review of a Norwegian prospective cohort study.

机构信息

Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.

Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.

出版信息

Paediatr Perinat Epidemiol. 2022 Sep;36(5):606-630. doi: 10.1111/ppe.12890. Epub 2022 Jul 22.

Abstract

BACKGROUND

Children born preterm with very low birthweight (VLBW) face long-lasting neurodevelopmental challenges, where multidisciplinary assessments are warranted. The International Classification of Functioning, Disability and Health (ICF) provides a framework for understanding and conceptualising these outcomes.

OBJECTIVES

We aimed to review clinical and neuroimaging findings from birth to adulthood in a Norwegian cohort of individuals born preterm with VLBW (gestational age <37 weeks, birthweight ≤1500 g) within the framework of ICF.

DATA SOURCES

We searched PubMed and Embase for articles reporting results of the Norwegian University of Science and Technology (NTNU) Low Birth Weight in a Lifetime Perspective study.

STUDY SELECTION AND DATA EXTRACTION

We included original articles reporting proportions of adverse outcomes, mean group differences, risk factors or associations between outcomes. Data were extracted according to ICF's two-level classification. Body functions and structures comprised outcomes of brain structures, cognition, mental health, vision, pain and physical health. Activities and participation comprised motor skills, general and social functioning, education, employment, and health-related quality of life.

SYNTHESIS

We performed a qualitative synthesis of included articles. Where mean (SD) was reported, we calculated group differences in SD units.

RESULTS

Fifty-eight publications were included. Within body functions and structures, increased prevalence of brain structure pathology, lower cognitive performance, mental health problems, visual and physical health impairments through childhood, adolescence and young adulthood were reported among preterm VLBW participants compared with controls. Within activities and participation, motor problems, lower general and social functioning, and lower academic attainment were found. Perinatal factors were associated with several outcomes, and longitudinal findings suggested persistent consequences of being born preterm with VLBW.

CONCLUSIONS

Being born preterm with VLBW has long-term influences on body functions and structures, activities and participation. The ICF is appropriate for assessing general domains of functioning and guiding the management of individuals born preterm with VLBW.

摘要

背景

极低出生体重早产儿(VLBW)面临长期的神经发育挑战,需要进行多学科评估。《国际功能、残疾和健康分类》(ICF)为理解和概念化这些结果提供了一个框架。

目的

我们旨在根据 ICF 框架,综述挪威一个出生时极早早产 VLBW(胎龄<37 周,出生体重≤1500 克)队列的个体从出生到成年的临床和神经影像学发现。

数据来源

我们在 PubMed 和 Embase 上搜索了报告挪威科技大学(NTNU)低出生体重终身研究结果的文章。

研究选择和数据提取

我们纳入了报告不良结局比例、组间平均差异、风险因素或结局之间关联的原始文章。根据 ICF 的两级分类提取数据。身体功能和结构包括脑结构、认知、心理健康、视力、疼痛和身体健康的结局。活动和参与包括运动技能、一般和社会功能、教育、就业和健康相关生活质量的结局。

综合

我们对纳入的文章进行了定性综合。在报告平均值(标准差)的情况下,我们计算了组间标准差单位的差异。

结果

纳入了 58 篇文章。在身体功能和结构方面,与对照组相比,极早早产 VLBW 参与者在儿童期、青春期和青年期表现出更高的脑结构病理发生率、认知表现较低、心理健康问题、视力和身体健康受损。在活动和参与方面,发现运动问题、一般和社会功能较低以及学业成绩较低。围产期因素与多种结局相关,且纵向研究结果表明,出生时极早早产 VLBW 存在长期后果。

结论

出生时极早早产 VLBW 对身体功能和结构、活动和参与有长期影响。ICF 适用于评估一般功能领域,并指导极早早产 VLBW 个体的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b5/9542186/97ecb261ff21/PPE-36-606-g002.jpg

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