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发育障碍概况及其与孕周的关联。

Profiles of developmental disorder and associations with gestational age.

作者信息

Pettinger Katherine Jane, Blower Sarah Louise, Boyle Elaine M, Hewitt Catherine Elizabeth, Fraser Lorna K

机构信息

Department of Health Sciences, University of York, York, UK

Department of Health Sciences, University of York, York, UK.

出版信息

Arch Dis Child. 2025 Jul 18;110(8):636-644. doi: 10.1136/archdischild-2024-327962.

Abstract

OBJECTIVE

This study aimed to examine profiles of co-occurrence of developmental disorders and their association with birth before full term.

DESIGN

Latent class analysis of cohort data with linked health data.

SETTING

Bradford, England.

PATIENTS

13 172 children were included in the analysis.

OUTCOME MEASURES

Developmental disorder in medical records.

METHODS

Data were censored at each child's 12th birthday. The latent class analysis identified patterns of developmental disorders. Multinomial logistic regression explored the association with gestational age while adjusting for clinical and socio-factors.

RESULTS

The majority (12,536) had a low risk of developmental disorders; this group was named 'typical development'. The remaining children were classified into three groups: 'educational difficulties' (347 children); 'social, emotional, behavioural and communication difficulties' (189 children) and 'early developmental impairment, with physical and intellectual disabilities' (100 children).Compared with 'typical development', very preterm birth was associated with an increased likelihood of being in the 'early developmental impairment, with physical and intellectual disabilities' group, adjusted relative risk ratio (aRRR): 9.22 (95% CI 4.58 to 18.55). Birth before full term was associated with increased likelihood of being in the 'educational difficulties' group; risk was highest <34 weeks (aRRR: 2.64 (95% CI 1.44 to 4.83)) but persisted up to 37-38 weeks: aRRR: 1.41 (95% CI 1.10 to 1.81). There was no association between gestational age and the 'social, emotional, behavioural and communication difficulties'' group.

CONCLUSION

Four distinct profiles of developmental disorders were identified; gestational age was associated with two of these. Understanding which disorders children are most at risk of and how these co-occur can help provide accurate information to families and contribute to prompt diagnosis.

摘要

目的

本研究旨在探讨发育障碍的共现情况及其与早产的关联。

设计

对队列数据与相关健康数据进行潜在类别分析。

地点

英国布拉德福德。

患者

13172名儿童纳入分析。

观察指标

病历中的发育障碍情况。

方法

数据截至每个儿童12岁生日时进行审查。潜在类别分析确定发育障碍模式。多项逻辑回归在调整临床和社会因素的同时探索与胎龄的关联。

结果

大多数(12536名)儿童发育障碍风险较低;该组被命名为“典型发育”。其余儿童分为三组:“教育困难”(347名儿童);“社交、情感、行为和沟通困难”(189名儿童)以及“早期发育障碍,伴有身体和智力残疾”(100名儿童)。与“典型发育”相比,极早产与处于“早期发育障碍,伴有身体和智力残疾”组的可能性增加相关,调整后的相对风险比(aRRR):9.22(95%可信区间4.58至18.55)。早产与处于“教育困难”组的可能性增加相关;风险在<34周时最高(aRRR:2.64(95%可信区间1.44至4.83)),但在37 - 38周时仍持续存在:aRRR:1.41(95%可信区间1.10至1.81)。胎龄与“社交、情感、行为和沟通困难”组之间无关联。

结论

确定了四种不同的发育障碍情况;胎龄与其中两种情况相关。了解儿童最易患哪些障碍以及这些障碍如何共同出现有助于向家庭提供准确信息并促进早期诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e048/12320604/94f084eaa01b/archdischild-110-8-g001.jpg

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