Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Int J Environ Res Public Health. 2023 Feb 14;20(4):3357. doi: 10.3390/ijerph20043357.
Developmental delay in neurocognitive function has been reported in premature children. This cohort study prospectively followed preterm infants following birth, and herein we present the four-year longitudinal follow-up data of cognitive development at preschool age and analyze correlated factors.
Term and preterm children received regular clinical evaluations and development assessments after birth, and at age 4 ± 1 years, they received the Wechsler-preschool and primary scale of intelligence, Fourth Edition (WPPSI-IV), excluding those with full-scale intelligence quotient < 70. A total of 150 participants received Conners Kiddie Continuous Performance Test (K-CPT), while 129 participants received ophthalmic evaluation. We adopted Chi-square test, ANOVA, and post hoc analysis to compare group differences. Correlations with K-CPT and WPPSI-IV were analyzed using Pearson's correlation.
Group 1 consisted of 25 full-term children, group 2 had 94 preterm children with birth-weight of ≥ 1500 g, and group 3 had 159 preterm children with birth-weight of < 1500 g. Group 1 was the healthiest group and had the best performance in attention and intelligence, while group 3 had the worst physical condition and cognitive performance. The correlation analysis revealed that perinatal factors, including gestational age, birth weight, Apgar scores, and physical conditions, significantly correlated with WPPSI-IV and K-CPT variables. Gender significantly correlated with object assembly of WPSSI-IV and clinical index of K-CPT. Among vision-related variables, best corrected visual acuity correlated most with K-CPT, including clinical index, Omission, and hit reaction time standard error of K-CPT, as well as significantly correlated with information and bug search of WPPSI-IV.
Preterm children at preschool age still had poorer cognitive performance than full-term children, especially those with birth BW less than 1500 g. Gender and vision are correlated with cognitive deficits. Continuous monitoring with comprehensive assessments is recommended.
已有研究报道，神经认知功能发育迟缓可发生于早产儿。本队列研究前瞻性随访了出生后的早产儿，在此我们呈现了其 4 岁时的认知发展纵向随访数据，并分析了相关因素。
足月和早产儿在出生后接受了常规的临床评估和发育评估，在 4 ± 1 岁时，他们接受了韦氏学前和小学智力量表第四版（WPPSI-IV）的测试，排除了智商得分<70 的个体。共有 150 名参与者接受了康纳斯儿童连续操作测试（K-CPT），129 名参与者接受了眼科评估。我们采用卡方检验、方差分析和事后分析来比较组间差异。采用 Pearson 相关分析 K-CPT 和 WPPSI-IV 之间的相关性。
第 1 组包括 25 名足月儿童，第 2 组包括 94 名出生体重≥1500g 的早产儿，第 3 组包括 159 名出生体重<1500g 的早产儿。第 1 组是健康状况最好的一组，注意力和智力表现最佳，而第 3 组的身体状况和认知表现最差。相关性分析表明，围产期因素，包括胎龄、出生体重、阿普加评分和身体状况，与 WPPSI-IV 和 K-CPT 变量显著相关。性别与 WPSSI-IV 的物体组装和 K-CPT 的临床指标显著相关。在与视力相关的变量中，最佳矫正视力与 K-CPT 的相关性最大，包括 K-CPT 的临床指数、遗漏和击中反应时间标准误差，以及与 WPPSI-IV 的信息和 bug 搜索显著相关。
学龄前早产儿的认知表现仍不如足月儿童，尤其是出生体重<1500g 的早产儿。性别和视力与认知缺陷相关。建议进行全面评估的连续监测。
