极早产儿的肺功能受损会导致其成年后出现注意力不集中的情况。

Impaired pulmonary function mediates inattention in young adults born extremely preterm.

机构信息

Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Division of Newborn Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.

出版信息

Acta Paediatr. 2023 Feb;112(2):254-260. doi: 10.1111/apa.16586. Epub 2022 Nov 12.

DOI:10.1111/apa.16586

PMID:36330674

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11562750/

Abstract

AIM

To test whether poor childhood pulmonary function explains the relationship between extremely preterm (EP) birth and attention-deficit/hyperactivity disorder (ADHD) symptoms in young adulthood.

METHODS

EPICure birth cohort participants include children born <26 weeks' gestation in the United Kingdom and Ireland in 1995 and their term-born classmates. Predictor was EP birth. Outcomes were inattention/hyperactivity subscale z-scores at 19 years. Forced expiratory volume (FEV1) z-scores in childhood and young adulthood were mediators. We used recursive path analysis to determine the direct effect of EP birth on inattention/hyperactivity and its indirect effect through pulmonary function.

RESULTS

Ninety EP and 47 term-born participants had pulmonary function testing at 11 and 19 years. Inattention z-scores were higher in the EP group (mean difference 0.55 [95% CI 0.11, 0.99]) but not hyperactivity. Compared to term-born peers, EP participants had lower FEV1 z-scores at 11 (mean difference-1.35 [95% CI -1.72, -0.98]) and 19 (mean difference-1.29 [95% CI -1.65, -0.92]). Path models revealed that childhood pulmonary function explained the relationship between EP birth and inattention.

CONCLUSIONS

Extremely preterm young adults have increased risk for inattention compared to term-born peers. Poor pulmonary function appears to underlie this risk. The mechanisms responsible remain unclear and warrant further study.

摘要

目的

检验儿童时期肺功能较差是否可以解释极早产（EP）与成年早期注意力缺陷多动障碍（ADHD）症状之间的关系。

方法

EPICure 出生队列的参与者包括在 1995 年于英国和爱尔兰胎龄<26 周出生的 EP 儿童及其足月出生的同学。预测因素为 EP 出生。结局为 19 岁时注意力不集中/多动障碍亚量表 z 评分。儿童期和成年早期的用力呼气量（FEV1）z 评分作为中介。我们采用递归路径分析来确定 EP 出生对注意力不集中/多动障碍的直接影响及其通过肺功能的间接影响。

结果

90 名 EP 儿童和 47 名足月出生儿童在 11 岁和 19 岁时进行了肺功能测试。EP 组的注意力不集中 z 评分较高（平均差异 0.55 [95% CI 0.11, 0.99]），但多动障碍评分无差异。与足月出生的同龄人相比，EP 参与者在 11 岁（平均差异-1.35 [95% CI -1.72, -0.98]）和 19 岁（平均差异-1.29 [95% CI -1.65, -0.92]）时的 FEV1 z 评分较低。路径模型显示，儿童时期的肺功能解释了 EP 出生与注意力不集中之间的关系。