Change in prevalence of chronic conditions between childhood and adolescence among extremely low-birth-weight children.
Change in prevalence of chronic conditions between childhood and adolescence among extremely low-birth-weight children.
复制标题
DOI：
10.1001/jama.2011.1025
复制
发表时间：
2011-07-27
影响因子：
120.7
通讯作者：
Cuttler, Leona
中科院分区：
文献类型：
--
作者：
Hack, Maureen;Schluchter, Mark;Andreias, Laura;Margevicius, Seunghee;Taylor, H. Gerry;Drotar, Dennis;Cuttler, Leona
极低出生体重（ELBW，<1公斤）的儿童在童年时期有很高的慢性病发生率。卫生保健规划需要了解他们在青春期这一关键时期的健康轨迹。检查与正常出生体重（NBW）对照组相比，ELBW中8至14岁慢性疾病发生率的变化。2004年至2009年在俄亥俄州克利夫兰市出生的181名ELBW儿童（体重<1 kg）和115名NBW对照儿童（1992年至1995年出生，社会人口学状况相似）中进行的队列研究。慢性病的总体发病率（用修订的慢性病儿童识别问卷测量）以及哮喘和肥胖的发病率。在ELBW儿童（8岁时为75%，14岁时为74%）或NBW对照（8岁时为37%，14岁时为47%）中，8至14岁之间慢性病的总体发病率没有显着变化。在广义估计方程logistic回归中，调整社会人口学状况、性别和种族，ELBW在14岁时的慢性病发生率继续高于NBW对照组（分别为74%和47%，调整后的比值比[AOR]，2.8; 95%置信区间{CI}，1.7 - 4.6）。ELBW儿童中需要药物治疗的哮喘发病率在8至14岁之间没有变化（两个年龄段均为23%），但NBW儿童中需要药物治疗的哮喘发病率从8岁时的8%增加到14岁时的17%（p=0.002）。在14岁时，ELBW和NBW儿童的哮喘发病率差异不再显著（分别为23%和17%; AOR，1.5; [95%CI，0.8 - 2.8]。ELBW儿童的体重指数平均z评分从8岁时的0.06增加到14岁时的0.38（p<0.001），肥胖率从8岁时的12%增加到14岁时的19%（p=0.02）。然而，NBW对照组的评分和比率没有变化，因此在14岁时，ELBW和NBW儿童的体重指数平均z评分差异（分别为0.38 vs 0.56;校正的平均差异为-0.2; 95% CI，-0.5至0.1）或肥胖率（分别为19% vs 20%; AOR为1.1 [95%CI为0.6 ~ 2.0]，差异无统计学意义。在ELBW儿童中，总体慢性病和哮喘的发病率在8 - 14岁之间没有变化，但肥胖的发病率增加。与NBW对照组相比，慢性疾病的发生率更高，但哮喘和肥胖的发生率没有显着差异。
Extremely low birth weight (ELBW, <1kg) children have high rates of chronic conditions during childhood. Information on their trajectory of health during the critical period of adolescence is needed for health care planning. To examine changes in rates of chronic conditions between age 8 and 14 years among ELBW compared to normal birth weight (NBW) controls. Cohort study conducted from 2004 through2009 of 181 ELBW children (weight <1kg) and 115 NBW controls of similar sociodemographic status born 1992 through 1995 in Cleveland, Ohio. Rates of chronic conditions overall (measured with the revised Questionnaire for Identifying Children with Chronic Conditions) and rates of asthma and obesity. The overall rates of chronic conditions did not change significantly between ages 8 and 14 years among ELBW children (75% at age 8 years vs 74% at age 14 years) or NBW controls (37% at 8 years vs 47% at age 14 years). In generalized estimating equations logistic regression, adjusting for sociodemographic status, sex and race, ELBW continued to have higher rates of chronic conditions than NBW controls at age 14 years (74% vs 47%, respectively adjusted odds ratio [AOR],2.8; 95% Confidence Interval {CI},1.7 to 4.6). Rates of asthma requiring medication did not change between 8 and 14 years among ELBW children (23% at both ages), but increased among NBW children from 8% at age 8 years to 17% at age 14 years (p=0.002). Differences in rates of asthma between ELBW and NBW children were no longer significant at the age of 14 years (23% vs 17%, respectively; AOR,1.5; [95%CI,0.8 to 2.8]. Mean z scores for body mass index increased in ELBW children from 0.06 at age 8 yesrs to 0.38 at age 14 years(p<0.001) and rates of obesity increased from 12% at age 8 years to 19% at age 14 years (p=0.02). However, the scores and rates did not change among NBW controls such that at the age of 14 years the differences between ELBW and NBW children in mean z-scores for body mass index (0.38 vs 0.56, respectively; adjusted mean difference −0.2; 95% CI, −0.5 to 0.1) or rates of obesity (19% vs 20%, respectively; AOR,1.1 [95%CI, 0.6to 2.0] were not significant.. Among ELBW children rates of overall chronic conditions and asthma did not change between the ages of 8 and 14 years but the rates of obesityincreased. Compared with NBW controls, the rates of chronic conditions were higher but there were no significant differences in the rates of asthma or obesity.
登录
查看更多内容
影响因子：
8
作者：
Breslau, N;Paneth, NS;Lucia, VC
通讯作者：
Lucia, VC
影响因子：
120.7
作者：
Hack, M;Taylor, HG;Klein, N
通讯作者：
Klein, N
影响因子：
4.4
作者：
Mai, XM;Gäddlin, PO;Leijon, I
通讯作者：
Leijon, I
影响因子：
8
作者：
Akinbami, Lara J.;Moorman, Jeanne E.;Sondik, Edward J.
通讯作者：
Sondik, Edward J.
影响因子：
--
作者：
Newacheck, PW;Kim, SE
通讯作者：
Kim, SE