Bando Nicole, Walton Kathryn, O'Connor Deborah L, Janus Magdalena, Unger Sharon L
Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
Child Care Health Dev. 2023 May;49(3):444-455. doi: 10.1111/cch.13058. Epub 2022 Sep 27.
Many children born very low birth weight (VLBW) experience school struggles with preparedness requiring adequate physical, social, behavioural, cognitive and communication skills. A global assessment of proficiency is necessary to identify those at risk in any such area and direct early intervention accordingly. Study objectives were to characterize developmental vulnerability and school readiness scores in these key domains in a sample of children born VLBW versus their provincial public school system peers and identify early-life infant and parent factors related to suboptimal school readiness.
The Early Development Instrument teacher assessments of school readiness were collected for a Canadian VLBW sample (NCT02759809). Comparisons between children born VLBW and peers were made. Group differences between children born VLBW considered vulnerable (<10th percentile, not developmentally ready for learning) and not vulnerable were tested and linear regression explored associations between early-life factors and domain scores.
Of 77 available Early Development Instrument assessments, median (interquartile range) assessment age was 6.0 (5.7, 6.2) years, birth weight 950 (793, 1250) grammes and birth gestation 27.4 (25.6, 29.7) weeks. A higher proportion of children born VLBW versus peers exhibited vulnerability in Physical Health and Well-being (24.7% vs. 16.1%, p = 0.04), Communication Skills and General Knowledge (23.4% vs. 10.2%, p = 0.0001) and vulnerability in ≥2 domains (26.0% vs. 14.4%, p = 0.004). Children born VLBW classified as vulnerable versus not vulnerable had lower birth gestation and 5-min Apgar. Adjusted regression models found Apgar <7 associated with lower scores for Physical Health and Well-being (-0.86; 95%CI: -1.71, -0.00; p = 0.049), Social Competence (-1.77; 95%CI: -2.92, -0.62; p = 0.003), Emotional Maturity (-1.55; 95%CI: -2.43, -0.66; p = 0.0009) and Communication Skills and General Knowledge (-1.63; 95%CI: -3.19, -0.06; p = 0.04).
This VLBW sample exhibited poor school readiness in multiple domains. Identification of lower birth gestation and Apgar may assist targeted early interventions to mitigate vulnerability.
许多极低出生体重（VLBW）儿在学校面临学习困难，需要具备足够的身体、社交、行为、认知和沟通技能。进行全面评估以确定在这些领域中存在风险的儿童，并据此进行早期干预十分必要。研究目的是描述极低出生体重儿样本在这些关键领域的发育脆弱性和入学准备分数，并确定与入学准备欠佳相关的早期婴儿和父母因素，同时将其与省级公立学校系统中的同龄人进行比较。
收集了加拿大极低出生体重儿样本（NCT02759809）的早期发育工具教师对入学准备情况的评估。对极低出生体重儿和同龄人进行了比较。对被认为脆弱（低于第10百分位数，未做好学习准备）和不脆弱的极低出生体重儿之间的组间差异进行了测试，并通过线性回归探讨了早期因素与各领域分数之间的关联。
在77份可用的早期发育工具评估中，评估年龄中位数（四分位间距）为6.0（5.7，6.2）岁，出生体重950（793，1250）克，出生孕周27.4（25.6，29.7）周。与同龄人相比，极低出生体重儿在身体健康和幸福感（24.7%对16.1%，p = 0.04）、沟通技能和常识（23.4%对10.2%，p = 0.0001）以及在≥2个领域存在脆弱性（26.0%对14.4%，p = 0.004）方面的比例更高。被归类为脆弱与不脆弱的极低出生体重儿出生孕周和5分钟阿氏评分较低。调整后的回归模型发现，阿氏评分<7与身体健康和幸福感得分较低（-0.86；95%置信区间：-
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