Behavioral outcome at 3 years of age in very preterm infants: The EPIPAGE study
Behavioral outcome at 3 years of age in very preterm infants: The EPIPAGE study
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DOI：
10.1542/peds.2005-2310
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发表时间：
2006-06-01
期刊：
影响因子：
8
通讯作者：
Larroque, Beatrice
中科院分区：
文献类型：
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作者：
Delobel-Ayoub, Malika;Kaminski, Monique;Larroque, Beatrice
目标.我们的目的是比较早产儿和足月儿3岁时行为问题的患病率，并研究与早产儿行为问题相关的因素。我们进行了一项基于人群的前瞻性队列研究：EPIPAGE（Etude Epidemiologique sur les Petits Ages Gestationnels）研究。1997年在法国9个地区妊娠22 - 32周出生的所有婴儿均纳入研究，并与足月出生的对照组婴儿进行比较。在出生时和新生儿病房收集社会人口学状况、产科和新生儿数据。在3岁时，1228名无主要神经障碍的早产单胎儿童和447名足月儿童的行为问题进行了研究，使用的优势和困难问卷由父母完成。极早产儿比对照组更有可能有行为困难。在极早产儿中，几种医疗条件与高的总难度评分相关：经颅超声检查诊断的新生儿脑损伤、过去一年内住院、健康状况差和精神发育迟缓。高出生顺序和社会人口因素，如年轻的母亲年龄和母亲的低教育水平也被确定为行为困难的危险因素。在调整了社会人口学特征、新生儿并发症、神经发育状况、高总困难评分、多动、行为问题和同伴问题后，极早产儿和对照组之间的差异仍然显著。对于情绪问题，差异在显著性的极限。与足月出生的孩子相比，早产儿在3岁时出现行为问题的风险更高。儿童的健康和神经发育状况与行为困难显著相关。
OBJECTIVES. Our goal was to compare the prevalence of behavioral problems between very preterm children and term children at 3 years of age and examine the factors associated with behavioral problems in very preterm children.METHODS. We conducted a prospective population-based cohort study: the EPIPAGE (Etude Epidemiologique sur les Petits Ages Gestationnels) study. All infants born between 22 and 32 weeks of gestation in 9 regions of France in 1997 were included and compared with a control group of infants born at term. Sociodemographic status, obstetric, and neonatal data were collected at birth and in the neonatal units. At 3 years of age, the behavioral problems of 1228 very preterm singleton children without major neurodisabilities, and 447 term children were studied using the Strengths and Difficulties Questionnaire completed by the parents.RESULTS. Very preterm children were more likely than controls to have behavioral difficulties. Among very preterm children, several medical conditions were associated with a high total difficulty score: major neonatal cerebral lesions diagnosed by cranial ultrasonographic studies, hospitalization within the last year, poor health, and psychomotor delay. A high birth order and sociodemographic factors such as young maternal age and low educational level of the mother were also identified as risk factors for behavioral difficulties. The differences between very preterm children and controls remained significant after adjustment for sociodemographic characteristics, neonatal complications, and neurodevelopmental status, for a high total difficulties score, hyperactivity, conduct problems, and for peer problems. For emotional problems, the difference was at the limit of significance.CONCLUSIONS. Very preterm children have a higher risk of behavioral problems at 3 years of age compared with term-born children. Health and neurodevelopmental status of the child were significantly associated with behavioral difficulties.