Varela-Moraga Virginia, Diethelm-Varela Benjamín, Pérez-Pereira Miguel
Departamento de Fonoaudiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Department of Molecular Genetics and Microbiology, School of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile.
Front Psychol. 2023 Jun 28;14:1163252. doi: 10.3389/fpsyg.2023.1163252. eCollection 2023.
Very and extremely preterm children have been found to show delays in the development of language in early years. In some investigations, however, a rigorous control of biomedical complications, such as Periventricular Leukomalacia (PVL), Intraventricular Hemorrhage (IVH) or Bronchopulmonary Dysplasia (BPD), does not always exist. For that reason, a confounding effect of low gestational age and biomedical complications may lead to erroneous conclusions about the effect of gestational age.
In this investigation we compare language development [use of words, sentence complexity and mean length of the three longest utterances (MLU3)] of three groups of Chilean children at 24 months of age (corrected age for preterm children). The first group was composed of 42 healthy full-term children (Full term group: FT), the second group of 60 preterm children born below 32 gestational weeks without medical complications (low risk preterm group: LRPT), and the third group was composed of 64 children below 32 gestational weeks who had medical complications (High risk preterm group: HRPT). The three groups were similar in terms of gender distribution, maternal education, and socio-economic environment. The instrument used to assess language was the Communicative Development Inventories (CDI). In addition, the Ages and Stages Questionnaire-3 (ASQ-3) was also used to assess other developmental dimensions.
The results indicate that HRPT and LRPT children obtained significantly lower results than the FT group in the three language measures obtained through the CDI. No significant differences were observed between the HRPT and the LRPT groups, although the HRPT obtained the lowest results in the three CDI measures. The results obtained through the administration of the ASQ-3 confirm the delay of both preterm groups in communicative development when compared to the FT group. No significant differences between the FT and the PT groups were observed in gross motor, fine motor and problem solving dimensions of the ASQ-3. The LRPT group obtained results that were significantly higher than those of the FT group and the HRPT group in gross motor development.
These results seem to indicate that the area of language development is particularly influenced by very or extremely low gestational age.
研究发现，极早产儿和超早产儿在早年语言发展方面存在延迟。然而，在一些调查中，对生物医学并发症（如脑室周围白质软化症（PVL）、脑室内出血（IVH）或支气管肺发育不良（BPD））的严格控制并非总是存在。因此，低孕周和生物医学并发症的混杂效应可能导致关于孕周影响的错误结论。
在本研究中，我们比较了三组智利儿童在24个月龄（早产儿为矫正年龄）时的语言发展情况[词汇使用、句子复杂性和三个最长话语的平均长度（MLU3）]。第一组由42名健康足月儿组成（足月儿组：FT），第二组由60名孕周低于32周且无医学并发症的早产儿组成（低风险早产组：LRPT），第三组由64名孕周低于32周且有医学并发症的儿童组成（高风险早产组：HRPT）。三组在性别分布、母亲教育程度和社会经济环境方面相似。用于评估语言的工具是交流发展量表（CDI）。此外，年龄与发育进程问卷-3（ASQ-3）也用于评估其他发育维度。
结果表明，通过CDI获得的三项语言测量中，HRPT组和LRPT组儿童的得分显著低于FT组。HRPT组和LRPT组之间未观察到显著差异，尽管HRPT组在三项CDI测量中得分最低。通过ASQ-3施测获得的结果证实，与FT组相比，两个早产组在交流发展方面均存在延迟。在ASQ-3的大运动、精细运动和问题解决维度上，FT组和PT组之间未观察到显著差异。LRPT组在大运动发展方面的得分显著高于FT组和HRPT组。
这些结果似乎表明，语言发展领域特别受极低或超低孕周的影响。
