McCarton C M, Brooks-Gunn J, Wallace I F, Bauer C R, Bennett F C, Bernbaum J C, Broyles R S, Casey P H, McCormick M C, Scott D T, Tyson J, Tonascia J, Meinert C L
Albert Einstein College of Medicine, Bronx, NY 10461, USA.
JAMA. 1997 Jan 8;277(2):126-32.
To reevaluate at age 8 years children who had participated during the first 3 years of life in a randomized clinical trial of special services for low-birthweight (LBW) premature infants.
Follow-up of a randomized controlled trial of premature infants (< or = 37 weeks' gestation), stratified by 2 LBW groups (lighter [< or = 2000 g] and heavier [2001-2500 g]) and divided into intervention (n=377) and follow-up only (n=608) groups.
Eight sites serving diverse populations.
At age 8 years, 874 children were assessed: 336 in the intervention group and 538 in the follow-up only group.
The 3-year intervention consisted of home visits (birth to 3 years), child development center services (ages 1 to 3 years), and parent group meetings (ages 1 to 3 years).
Cognitive functioning (Weschler Intelligence Scale for Children-III; Peabody Picture Vocabulary Test-Revised); academic achievement (Woodcock-Johnson Tests of Achievement-Revised); and parental reports of school performance, behavior (Child Behavior Checklist), and health (Child General Health Survey).
At age 8 years, in the entire cohort and in the lighter LBW stratum, the intervention and follow-up only groups were similar on all primary outcome measures. Differences favoring the intervention group were found within the heavier LBW group: full-scale IQ score (4.4 points higher, P=.007), verbal IQ score (4.2 points higher, P=.01), performance IQ score (3.9 points higher, P=.02), mathematics achievement score (4.8 points higher, P=.04), and receptive vocabulary score (6.7 points higher, P=.001). On a physical functioning subscale, the whole intervention group received less favorable ratings, while the lighter LBW intervention group had lower maternal ratings assessing social limitations caused by behavior.
Although at age 8 years there were modest intervention-related differences in the cognitive and academic skills of heavier LBW premature children, attenuation of the large favorable effects seen at 3 years was observed in both the heavier and lighter LBW groups. This indicates a need to develop additional intervention strategies for LBW premature children that can provide sustained benefits.
对出生后前3年参与低出生体重（LBW）早产儿特殊服务随机临床试验的儿童在8岁时进行重新评估。
对早产儿（孕周≤37周）的随机对照试验进行随访，按两个低出生体重组（较轻组[≤2000克]和较重组[2001 - 2500克]）分层，并分为干预组（n = 377）和仅随访组（n = 608）。
8个服务不同人群的地点。
在8岁时，对874名儿童进行了评估：干预组336名，仅随访组538名。
为期3年的干预包括家访（从出生到3岁）、儿童发展中心服务（1至3岁）和家长小组会议（1至3岁）。
认知功能（韦氏儿童智力量表第三版；皮博迪图片词汇测验修订版）；学业成绩（伍德库克 - 约翰逊成就测验修订版）；以及家长对学校表现、行为（儿童行为清单）和健康（儿童一般健康调查）的报告。
在8岁时，在整个队列以及较轻低出生体重亚组中，干预组和仅随访组在所有主要结局指标上相似。在较重低出生体重组中发现了有利于干预组的差异：全量表智商得分（高4.4分，P = 0.007）、言语智商得分（高4.2分，P = 0.01）、操作智商得分（高3.9分，P = 0.02）、数学成就得分（高4.8分，P = 0.04）和接受性词汇得分（高6.7分，P = 0.001）。在身体功能子量表上，整个干预组得到的评分较低，而较轻低出生体重干预组的母亲对因行为导致的社会限制的评分较低。
虽然在8岁时，较重低出生体重早产儿的认知和学术技能存在与干预相关的适度差异，但在较重和较轻低出生体重组中均观察到3岁时所见的巨大有益效果有所减弱。这表明需要为低出生体重早产儿制定额外的干预策略，以提供持续的益处。
