Behavioral and emotional adjustment of teenagers in mainstream school who were born before 29 weeks' gestation
Behavioral and emotional adjustment of teenagers in mainstream school who were born before 29 weeks' gestation
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DOI：
10.1542/peds.2003-0763-l
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发表时间：
2004-09-01
期刊：
影响因子：
8
通讯作者：
Wariyar, U
中科院分区：
文献类型：
--
作者：
Gardner, F;Johnson, A;Wariyar, U
目标。从父母、教师和青少年的角度探讨超低胎龄（ELGA） 15 ~ 16岁儿童的行为和情绪问题及积极适应情况。对出生队列进行前瞻性随访，教室对照受试者。研究对象是居住在英国3个地区的母亲在1983-1984年（平均胎龄：27周）29周前出生的所有婴儿。总共有82%（218人中有179人）的幸存者在15至16岁时被追踪。将150名主流学校的学生与108名年龄和性别匹配的课堂对照组进行比较。行为和情绪问题、犯罪、同伴关系、自尊和爱好，通过标准化的、有效的工具进行评估，包括优势和困难问卷，通过邮寄给父母、青少年和老师。与对照组相比，父母更有可能将ELGA青少年评为多动症（8%对1%；差异：7%；（95%置信区间[CI]: 2-12）、同伴关系问题（19%对5%；差异：14%；95% CI: 6-21）和情绪问题（18%对7%；差异：11%；95% CI: 3-19）的“异常”范围，但不包括行为问题（10%对5%；差异：5%；95% CI: -1至12））。教师们也报告了类似的模式。相比之下，与控制对象相比，ELGA青少年并没有认为自己有更多的同龄人问题、多动症、行为不良、抑郁或自卑。他们报告了更多的情绪问题，但更少的犯罪、酒精、大麻和其他药物的使用。与主流的同学相比，出生极早的孩子在父母和老师报告的情绪、注意力和同伴问题上的水平更高，直到青少年时期。然而，尽管有这些问题，他们并没有表现出更严重的行为障碍、犯罪、吸毒或抑郁的迹象。
Objectives. To investigate behavioral and emotional problems and positive adjustment of 15- to 16-year-olds who were born at extremely low gestational age (ELGA), from the perspective of parents, teachers, and teenagers.Methods. Prospective follow-up was conducted of birth cohorts, with classroom control subjects. All infants who were born before 29 weeks in 1983-1984 (mean gestational age: 27 weeks) to mothers who resided in 3 regions of the United Kingdom were studied. A total of 82% (179 of 218) of survivors were traced at age 15 to 16. The 150 in mainstream school were compared with age- and gender-matched classroom control subjects (n=108). Behavioral and emotional problems, delinquency, peer relations, self-esteem, and hobbies, were assessed by standardized, well-validated instruments, including the Strengths and Difficulties Questionnaire, administered by mail to parents, teenagers, and teachers.Results. Parents were more likely to rate ELGA teenagers than control subjects as in the "abnormal" range for hyperactivity (8% vs 1%; difference: 7%; (95% confidence interval [CI]: 2-12), peer relationship problems (19% vs 5%; difference: 14%; 95% CI: 6-21), and emotional problems (18% vs 7%; difference: 11%; 95% CI: 3-19), but not conduct problems (10% vs 5%; difference: 5%; 95% CI: -1 to 12)). Teachers reported a similar pattern. In contrast, compared with control subjects, ELGA teenagers did not rate themselves as having more problems with peers, hyperactivity, conduct, depression, or low self-esteem. They reported more emotional problems but less delinquency, alcohol, cannabis, and other drug use.Conclusions. Compared with mainstream classmates, children who are born extremely early continue to have higher levels of parent- and teacher-reported emotional, attentional, and peer problems well into their teens. However, despite these problems, they do not show signs of more serious conduct disorders, delinquency, drug use, or depression.