Larsen Jennifer, Holland Josephine, Kochhar Puja, Wolke Dieter, Draper Elizabeth S, Marlow Neil, Johnson Samantha
University of Leicester, Leicester, United Kingdom.
University of Nottingham Nottingham, United Kingdom.
JAACAP Open. 2024 Sep;2(3):217-228. doi: 10.1016/j.jaacop.2024.02.005.
This study aimed to identify the prevalence of psychiatric disorders in 2 population-based cohorts of children born extremely preterm (EP) 11 years apart to ascertain whether psychiatric outcomes have changed over time following improved survival of EP children.
In the EPICure2 study, 200 children born EP (22-26 weeks' gestation) in England in 2006 were assessed at 11 years of age alongside 143 term-born children. Children were assessed using the Developmental and Wellbeing Assessment (DAWBA). diagnoses were assigned by clinical psychiatrists for 145 EP and 98 term-born children. Outcomes were compared between a subsample of children from the EPICure2 cohort (2006, n = 76) and the earlier-born EPICure (1995, n = 161) cohort born at 22 to 25 weeks' gestation in England.
EP children in EPICure2 were significantly more likely than term-born children to have any psychiatric disorder (39.3% vs 3.1%; adjusted odds ratio [OR] = 15.1, 95% CI = 4.4-51.1), emotional disorders (14.6% vs 2.0%; OR = 7.3, 95% CI = 1.6-32.7), conduct disorders (6.3% vs 0.0%, .01), attention-deficit/hyperactivity disorder (ADHD, 21.9% vs 2.6%; OR = 7.2; 95% CI = 1.5-33.6), and autism spectrum disorder (ASD, 18.9%; vs 0.0%, .001). There was no significant difference in the rates of any psychiatric disorder between EP children in the EPICure2 and EPICure cohorts.
EP children remain at increased risk for psychiatric disorders at 11 years of age compared with term-born peers. Increased survival has not translated into improved psychiatric outcomes. Health care professionals need to be aware of this ongoing risk when caring for children born preterm.
本研究旨在确定两组基于人群的、出生间隔11年的极早产儿（EP）队列中精神障碍的患病率，以确定随着EP儿童存活率的提高，精神疾病结局是否随时间发生了变化。
在EPICure2研究中，2006年在英格兰出生的200名EP儿童（妊娠22 - 26周）在11岁时与143名足月儿一起接受评估。使用发育与幸福评估（DAWBA）对儿童进行评估。临床精神科医生为145名EP儿童和98名足月儿做出诊断。将EPICure2队列（2006年，n = 76）和英格兰1995年出生的、妊娠22至25周的较早出生的EPICure队列（n = 161）中的儿童子样本的结局进行比较。
与足月儿相比，EPICure2中的EP儿童患任何精神障碍的可能性显著更高（39.3%对3.1%；调整优势比[OR]=15.1，95%置信区间[CI]=4.4 - 51.1）、情绪障碍（14.6%对2.0%；OR = 7.3，95% CI = 1.6 - 32.7）、品行障碍（6.3%对0.0%，P <.01）、注意力缺陷/多动障碍（ADHD，21.9%对2.6%；OR = 7.2；95% CI = 1.5 - 33.6）和自闭症谱系障碍（ASD，18.9%对0.0%，P <.001）。EPICure2队列和EPICure队列中的EP儿童在任何精神障碍的发生率上没有显著差异。
与足月儿同龄人相比，EP儿童在11岁时患精神障碍的风险仍然增加。存活率的提高并未转化为精神疾病结局的改善。医护人员在照顾早产儿童时需要意识到这种持续存在的风险。
