Brooks-Gunn J, McCarton C M, Casey P H, McCormick M C, Bauer C R, Bernbaum J C, Tyson J, Swanson M, Bennett F C, Scott D T
Center for Children and Families, Teachers College, Columbia University, New York, NY 10027.
JAMA. 1994 Oct 26;272(16):1257-62.
To evaluate the persistence of effects on health and development at age 5 years of the Infant Health and Development Program, an early childhood intervention that was provided to low-birth-weight (LBW) premature infants from neonatal discharge through age 3 years.
Randomized, controlled, multicenter trial, stratified by two LBW groups: lighter (< or = 2000 g) and heavier (2001 to 2500 g).
Eight socioeconomically heterogeneous clinical sites.
Of 985 eligible infants weighing 2500 g or less and at 37 weeks' or less gestational age, 377 infants were randomly assigned to the intervention group and 608 to the follow-up only group. About two thirds of the infants in each group were in the lighter LBW stratum, and one third were in the heavier LBW stratum.
The intervention group received home visits (from neonatal discharge through age 3 years) as well as center-based schooling (from 1 to 3 years of age). Children in both groups received pediatric surveillance.
Cognitive development, behavioral competence, and health status.
At age 5 years, the intervention group had full-scale IQ scores similar to children in the follow-up only group. However, in the heavier LBW stratum, children in the intervention group had higher full-scale IQ scores (3.7 points higher; P = .03) and higher verbal IQ scores (4.2 points higher; P = .02). No significant differences between intervention and follow-up only groups in cognitive measures at age 5 years were noted in the lighter LBW infants. The intervention and follow-up groups were similar in behavior and health measures regardless of LBW stratum.
The early childhood intervention provided in the first 3 years of life had effects on heavier LBW premature infants' IQ and verbal performance at age 5 years that were not observed for lighter LBW premature infants. The intervention did not affect health or behavior at age 5 years in either LBW stratum.
评估婴儿健康与发展项目对5岁儿童健康和发育的持续影响。该项目是一项针对低出生体重（LBW）早产儿的早期儿童干预措施，从新生儿出院至3岁实施。
随机对照多中心试验，按两个低出生体重组分层：较轻组（≤2000克）和较重组（2001至2500克）。
八个社会经济情况各异的临床地点。
985名符合条件、体重2500克及以下、胎龄37周及以下的婴儿中，377名婴儿被随机分配至干预组，608名婴儿被分配至仅随访组。每组约三分之二的婴儿属于较轻低出生体重层，三分之一属于较重低出生体重层。
干预组接受家访（从新生儿出院至3岁）以及中心幼儿园教育（1至3岁）。两组儿童均接受儿科监测。
认知发育、行为能力和健康状况。
在5岁时，干预组的全量表智商得分与仅随访组儿童相似。然而，在较重低出生体重层中，干预组儿童的全量表智商得分更高（高3.7分；P = 0.03），言语智商得分更高（高4.2分；P = 0.02）。在较轻低出生体重婴儿中，5岁时干预组和仅随访组在认知指标上未发现显著差异。无论低出生体重层如何，干预组和随访组在行为和健康指标方面相似。
生命最初3年提供的早期儿童干预对较重低出生体重早产儿5岁时的智商和言语表现有影响，而较轻低出生体重早产儿未观察到这种影响。该干预对两个低出生体重层儿童5岁时的健康或行为均无影响。
