Niutanen Ulla, Lönnberg Piia, Wolford Elina, Metsäranta Marjo, Lano Aulikki
Department of Child Neurology, New Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
Front Psychol. 2022 Dec 1;13:996472. doi: 10.3389/fpsyg.2022.996472. eCollection 2022.
This study investigated minor impairments in neurological, sensorimotor, and neuropsychological functioning in extremely preterm-born (EPT) children compared to term-born children. The aim was to explore the most affected domains and to visualize their co-occurrences in relationship maps.
A prospective cohort of 56 EPT children (35 boys) and 37 term-born controls (19 boys) were assessed at a median age of 6 years 7 months with Touwen Neurological Examination, Movement Assessment Battery for Children, 2nd edition (MABC-2), Sensory Integration and Praxis Test (SIPT), and a Developmental Neuropsychological Assessment, 2nd edition (NEPSY-II). Altogether 20 test domains were used to illustrate the frequency of impaired test performances with a bar chart profile and to construct relationship maps of co-occurring impairments.
The EPT children were more likely to perform inferiorly compared to the term-born controls across all assessments, with a wider variance and more co-occurring impairments. When aggregating all impaired test domains, 45% of the EPT children had more impaired domains than any term-born child (more than five domains, < 0.001). Relationship maps showed that minor neurological dysfunction (MND), NEPSY-II design copying, and SIPT finger identification constituted the most prominent relationship of co-occurring impairments in both groups. However, it was ten times more likely in the EPT group. Another relationship of co-occurring MND, impairment in NEPSY-II design copying, and NEPSY-II imitation of hand positions was present in the EPT group only.
Multiple minor impairments accumulate among EPT children at six years, suggesting that EPT children and their families may need support and timely multi-professional interventions throughout infancy and childhood.
本研究调查了极早产儿（EPT）与足月儿相比在神经、感觉运动和神经心理功能方面的轻微损伤。目的是探索受影响最大的领域，并在关系图中直观呈现它们的共现情况。
对56名极早产儿（35名男孩）和37名足月儿对照（19名男孩）组成的前瞻性队列进行评估，评估时的中位年龄为6岁7个月，评估内容包括图温神经检查、儿童运动评估量表第二版（MABC - 2）、感觉统合与实践测试（SIPT）以及发展性神经心理评估第二版（NEPSY - II）。总共使用20个测试领域，通过柱状图展示测试表现受损的频率，并构建共现损伤的关系图。
在所有评估中，极早产儿比足月儿对照更有可能表现较差，差异更大且共现损伤更多。汇总所有受损测试领域时，45%的极早产儿受损领域比任何足月儿都多（超过五个领域，<0.001）。关系图显示，轻微神经功能障碍（MND）、NEPSY - II设计临摹以及SIPT手指识别在两组中构成了共现损伤最显著的关系。然而，在极早产儿组中这种情况出现的可能性是足月儿组的十倍。仅在极早产儿组中存在另一种共现关系，即MND、NEPSY - II设计临摹受损以及NEPSY - II手部姿势模仿受损。
极早产儿在6岁时会累积多种轻微损伤，这表明极早产儿及其家庭在婴儿期和儿童期可能需要支持以及及时的多专业干预。
