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2 岁校正年龄时采用年龄与阶段问卷评估的早产儿在 5.5 岁时的神经发育:EPIPAGE-2 队列研究。

Neurodevelopment at age 5.5 years according to Ages & Stages Questionnaire at 2 years' corrected age in children born preterm: the EPIPAGE-2 cohort study.

机构信息

Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, F-75004 Paris, France

Department of Neonatology, Saint Vincent de Paul Hospital, GHICL, F -59800 Lille, France.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2024 Aug 16;109(5):519-526. doi: 10.1136/archdischild-2023-325928.

Abstract

OBJECTIVE

To report neurodevelopment at age 5.5 years according to developmental delay screening with the Ages & Stages Questionnaire (ASQ) in late infancy in preterm-born children.

DESIGN

Population-based cohort study, EPIPAGE-2.

SETTING

France, 2011-2017.

PARTICIPANTS

2504 children born at 24-26, 27-31 and 32-34 weeks, free of cerebral palsy, deafness or blindness at 2 years' corrected age.

MAIN OUTCOME MEASURES

Moderate/severe, mild or no disability at age 5.5 years using gross and fine motor, sensory, cognitive and behavioural evaluations. Results of the ASQ completed between 22 and 26 months' corrected age described as positive screening or not.

RESULTS

Among 2504 participants, 38.3% had ASQ positive screening. The probability of having moderate/severe or mild disability was higher for children with ASQ positive versus negative screening: 14.2% vs 7.0%, adjusted OR 2.5 (95% CI 1.8 to 3.4), and 37.6% vs 29.7%, adjusted OR 1.5 (1.2 to 1.9). For children with ASQ positive screening, the probability of having neurodevelopmental disabilities at age 5.5 years was associated with the number of domain scores below threshold, very low gestational age and severe neonatal morbidities. For children with ASQ negative screening, this probability was increased for boys and children born small-for-gestational age. For both groups, maternal level of education was strongly associated with outcomes.

CONCLUSION

In preterm-born children, ASQ screening at 2 years' corrected age was associated with neurodevelopmental disabilities at age 5.5 years. However, other factors should be considered when interpreting the ASQ data to draw further follow-up.

TRIAL REGISTRATION NUMBER

2016-A00333-48.

摘要

目的

根据婴幼儿期年龄与阶段问卷(ASQ)发育迟缓筛查结果,报告早产儿在 5.5 岁时的神经发育情况。

设计

基于人群的队列研究,EPIPAGE-2。

地点

法国,2011-2017 年。

参与者

2504 名婴儿出生于 24-26、27-31 和 32-34 周,2 岁时无脑瘫、耳聋或失明。

主要观察指标

5.5 岁时使用粗大和精细运动、感觉、认知和行为评估评估为中重度/轻度或无残疾。将在 22 至 26 个月校正年龄期间完成的 ASQ 结果描述为阳性筛查或阴性筛查。

结果

在 2504 名参与者中,38.3%的 ASQ 筛查阳性。ASQ 阳性筛查与阴性筛查的儿童中,有中重度/轻度残疾的可能性更高:14.2%比 7.0%,调整后的 OR 2.5(95%CI 1.8 至 3.4)和 37.6%比 29.7%,调整后的 OR 1.5(1.2 至 1.9)。对于 ASQ 阳性筛查的儿童,5.5 岁时出现神经发育障碍的可能性与域评分低于阈值的数量、极低胎龄和严重新生儿合并症有关。对于 ASQ 阴性筛查的儿童,这种可能性在男孩和小于胎龄出生的儿童中增加。对于两组儿童,母亲的教育水平与结果密切相关。

结论

在早产儿中,2 岁校正年龄时的 ASQ 筛查与 5.5 岁时的神经发育障碍相关。然而,在解释 ASQ 数据以进行进一步随访时,还应考虑其他因素。

试验注册号

2016-A00333-48。

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