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极低出生体重早产儿矫正年龄两岁时语言发育迟缓的风险因素:一项基于人群的研究。

Risk Factors of Language Delay at Two Years of Corrected Age among Very-Low-Birth-Weight Preterm Infants: A Population-Based Study.

作者信息

Tseng Wei-Lun, Chen Chia-Huei, Chang Jui-Hsing, Peng Chun-Chih, Jim Wai-Tim, Lin Chia-Ying, Hsu Chyong-Hsin, Liu Tzu-Yu, Chang Hung-Yang

机构信息

Department of Pediatrics, MacKay Children's Hospital, Taipei 104217, Taiwan.

Department of Medicine, MacKay Medical College, New Taipei City 251020, Taiwan.

出版信息

Children (Basel). 2023 Jan 19;10(2):189. doi: 10.3390/children10020189.

Abstract

Language delays are often underestimated in very-low-birth-weight (VLBW) preterm infants. We aimed to identify the risk factors of language delay at two years of corrected age in this vulnerable population. VLBW infants, who were assessed at two years of corrected age using the Bayley Scale of Infant Development, third edition, were included using a population-based cohort database. Language delay was defined as mild to moderate if the composite score was between 70 and 85 and severe if the score was < 70. Multivariable logistic regression analysis was used to identify the perinatal risk factors associated with language delay. The study comprised 3797 VLBW preterm infants; 678 (18%) had a mild to moderate delay and 235 (6%) had a severe delay. After adjusting for confounding factors, low maternal education level, low maternal socioeconomic status, extremely low birth weight, male sex, and severe intraventricular hemorrhage (IVH) and/or cystic periventricular leukomalacia (PVL) were found to be significantly associated with both mild to moderate and severe delays. Resuscitation at delivery, necrotizing enterocolitis, and patent ductus arteriosus requiring ligation showed significant associations with severe delay. The strongest factors predicting both mild to moderate and severe language delays were the male sex and severe IVH and/or cystic PVL; thus, early targeted intervention is warranted in these populations.

摘要

极低出生体重(VLBW)早产儿的语言发育迟缓常常被低估。我们旨在确定这一脆弱群体在矫正年龄两岁时语言发育迟缓的风险因素。使用基于人群的队列数据库纳入了在矫正年龄两岁时使用贝利婴幼儿发展量表第三版进行评估的极低出生体重婴儿。如果综合得分在70至85之间,则将语言发育迟缓定义为轻度至中度;如果得分低于70,则定义为重度。采用多变量逻辑回归分析来确定与语言发育迟缓相关的围产期风险因素。该研究包括3797名极低出生体重早产儿;678名(18%)有轻度至中度发育迟缓,235名(6%)有重度发育迟缓。在对混杂因素进行调整后,发现母亲教育水平低、母亲社会经济地位低、极低出生体重、男性性别以及重度脑室内出血(IVH)和/或脑室周围白质软化症(PVL)与轻度至中度和重度发育迟缓均显著相关。分娩时的复苏、坏死性小肠结肠炎以及需要结扎的动脉导管未闭与重度发育迟缓显著相关。预测轻度至中度和重度语言发育迟缓的最强因素是男性性别以及重度IVH和/或囊性PVL;因此,对这些人群进行早期针对性干预是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bce2/9955016/5b3592141437/children-10-00189-g001.jpg

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