Late-Preterm Birth and Its Association With Cognitive and Socioemotional Outcomes at 6 Years of Age
Late-Preterm Birth and Its Association With Cognitive and Socioemotional Outcomes at 6 Years of Age
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DOI：
10.1542/peds.2010-1536
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发表时间：
2010-12-01
期刊：
影响因子：
8
通讯作者：
Breslau, Naomi
中科院分区：
文献类型：
--
作者：
Talge, Nicole M.;Holzman, Claudia;Breslau, Naomi
前言：晚期早产（妊娠34-36周）与长期认知和社会情绪问题的风险有关。然而，许多研究并没有纳入这些结果的重要贡献者的措施，目前还不清楚是否归因于胎龄的影响是独立于胎儿生长或其代理，出生体重胎龄。方法：数据来自于1983年和1985年之间的城市和郊区设置的低体重和正常体重出生的研究（低出生体重，n = 473;正常出生体重; n = 350）。使用随机抽样将晚早产的单胎与其出生体重z评分在其匹配的0.1 SD内的足月对应物配对（n = 168对）。通过随机效应模型，我们评估了两人在6岁时的智商得分和教师报告的行为问题是否存在差异。（校正比值比[aOR]：2.35 [95%置信区间（CI）：1.20-4.61]）和体能（aOR：2.04 [95% CI：1.09-3.82]）IQ评分低于85。晚期早产与更高水平的内化和注意力问题相关，这些发现在使用阈值标记边界或临床显著问题的模型中得到了复制（aOR：2.35 [95%CI：1.28-4.32]和1.76 [95%CI：1.04-3.0]）。晚期早产与6岁时的行为问题和低智商相关，与母亲智商、居住环境和社会人口统计学无关。未来的研究需要调查这些结果是否是由于妊娠期缩短，子宫内（如产科并发症）或子宫外（如新生儿并发症）因素标志着晚期早产，或这些因素的某种组合。儿科2010; 126：1124-1131
INTRODUCTION: Late-preterm birth (34-36 weeks' gestation) has been associated with a risk for long-term cognitive and socioemotional problems. However, many studies have not incorporated measures of important contributors to these outcomes, and it is unclear whether effects attributed to gestational age are separate from fetal growth or its proxy, birth weight for gestational age.METHOD: Data came from a study of low-and normal-weight births sampled from urban and suburban settings between 1983 and 1985 (low birth weight, n = 473; normal birth weight; n = 350). Random sampling was used to pair singletons born late-preterm with a term counterpart whose birth weight z score was within 0.1 SD of his or her match (n = 168 pairs). With random-effects models, we evaluated whether pairs differed in their IQ scores and teacher-reported behavioral problems at the age of 6 years.RESULTS: In adjusted models, late-preterm birth was associated with an increased risk of full-scale (adjusted odds ratio [aOR]: 2.35 [95% confidence interval (CI): 1.20-4.61]) and performance (aOR: 2.04 [95% CI: 1.09-3.82]) IQ scores below 85. Late-preterm birth was associated with higher levels of internalizing and attention problems, findings that were replicated in models that used thresholds marking borderline or clinically significant problems (aOR: 2.35 [95% CI: 1.28-4.32] and 1.76 [95% CI: 1.04-3.0], respectively).CONCLUSIONS: Late-preterm birth is associated with behavioral problems and lower IQ at the age of 6, independent of maternal IQ, residential setting, and sociodemographics. Future research is needed to investigate whether these findings result from a reduction in gestational length, in utero (eg, obstetric complications) or ex-utero (eg, neonatal complications) factors marked by late-preterm birth, or some combination of these factors. Pediatrics 2010; 126: 1124-1131