Bowen J R, Starte D R, Arnold J D, Simmons J L, Ma P J, Leslie G I
Department of Neonatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
J Paediatr Child Health. 1993 Aug;29(4):276-81. doi: 10.1111/j.1440-1754.1993.tb00511.x.
This study documents the neurodevelopmental outcome at 3 years of 52 of 55 extremely low birthweight (ELBW) survivors (survival rate 49%) born in a tertiary maternity centre from July 1985 through December 1988, and examines more closely the developmental profile of the neurologically normal survivors. At 3 years, 6 (12%) children had severe neurodevelopmental impairment (severe cerebral palsy, blindness, deafness or a General Quotient (GQ) < 70 on the Griffiths Scales), 11 (21%) had mild to moderate impairment and 35 (67%) had no neurosensory impairment and normal development (GQ > or = 85). Significant risk factors for severe impairment were stage 3 or 4 retinopathy of prematurity (odds ratio [OR] 21.5), treatment with postnatal steroids (OR 21), grade III or IV intraventricular haemorrhage (OR 11) and supplemental oxygen at 'term' (OR 6.4). The developmental profile of the 35 neurologically normal children revealed a significant weakness in eye and hand coordination skills and a relative strength in hearing and speech skills. Early recognition of this developmental profile may allow implementation of more appropriate preschool programmes for ELBW children.
本研究记录了1985年7月至1988年12月在一家三级产科中心出生的55名极低出生体重（ELBW）存活者中的52名（存活率49%）3岁时的神经发育结局，并更仔细地研究了神经功能正常的存活者的发育概况。3岁时，6名（12%）儿童有严重神经发育障碍（严重脑瘫、失明、失聪或在格里菲斯量表上的总商数（GQ）<70），11名（21%）有轻度至中度障碍，35名（67%）没有神经感觉障碍且发育正常（GQ≥85）。严重障碍的显著危险因素为3期或4期早产儿视网膜病变（比值比[OR]21.5）、出生后使用类固醇治疗（OR 21）、III级或IV级脑室内出血（OR 11）以及“足月”时吸氧（OR 6.4）。35名神经功能正常儿童的发育概况显示，他们在眼手协调技能方面存在显著弱点，而在听力和语言技能方面相对较强。尽早认识到这种发育概况可能有助于为ELBW儿童实施更合适的学前教育项目。
