Landgren M, Kjellman B, Gillberg C
Department of Child and Adolescent Psychiatry, Göteborg University, Annedals Clinics, Sweden.
Arch Dis Child. 1998 Sep;79(3):207-12. doi: 10.1136/adc.79.3.207.
To analyse the contribution of certain social, familial, prenatal, perinatal, and developmental background factors in the pathogenesis of deficits in attention, motor control, and perception (DAMP).
A population based case-control study was carried out with 113 children aged 6 years, 62 diagnosed with DAMP and 51 controls without DAMP. The children's health and medical records were studied and their history with regard to background factors was taken at an interview with the mother using a standardised schedule. Familial factors, possible non-optimal factors during pregnancy (including smoking), developmental factors (including early language development), and medical and psychosocial data were scored in accordance with the reduced optimality method.
Low socioeconomic class was common in the group with DAMP. Familial language disorder and familial motor clumsiness were found at higher rates in the DAMP group. Neuropathogenic risk factors in utero were also more common in the children with DAMP. Maternal smoking during pregnancy appeared to be an important risk factor. Language problems were present in two thirds of the children with DAMP. Sleep problems and gastrointestinal disorders, but not atopy or otitis media, were significantly more common in the DAMP group.
Prenatal familial and neuropathogenic risk factors contribute to the development of DAMP. Primary prevention, such as improved maternal health care and early detection or treatment, or both, of associated language problems appear to be essential.
分析某些社会、家庭、产前、围产期及发育背景因素在注意力、运动控制和感知缺陷(DAMP)发病机制中的作用。
开展一项基于人群的病例对照研究,研究对象为113名6岁儿童,其中62名被诊断为DAMP,51名无DAMP的儿童作为对照。研究儿童的健康和医疗记录,并通过标准化问卷与母亲访谈获取其背景因素相关病史。根据优化程度降低法对家庭因素、孕期可能的非最佳因素(包括吸烟)、发育因素(包括早期语言发育)以及医疗和社会心理数据进行评分。
DAMP组中社会经济阶层较低的情况较为常见。DAMP组中家庭语言障碍和家庭运动笨拙的发生率更高。宫内神经致病危险因素在DAMP儿童中也更常见。孕期母亲吸烟似乎是一个重要的危险因素。三分之二的DAMP儿童存在语言问题。睡眠问题和胃肠道疾病在DAMP组中明显更为常见,但特应性或中耳炎并非如此。
产前家庭和神经致病危险因素促成了DAMP的发生。初级预防措施,如改善孕产妇保健以及早期发现或治疗相关语言问题,或两者兼施,似乎至关重要。