Impaired pulmonary function mediates inattention in young adults born extremely preterm.
Impaired pulmonary function mediates inattention in young adults born extremely preterm.
复制标题
肺功能受损会导致极早产的年轻人注意力不集中。
DOI：
10.1111/apa.16586
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Tiemeier,Henning
中科院分区：
文献类型：
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作者：
Litt,JonathanS;Johnson,Samantha;Marlow,Neil;Tiemeier,Henning
目的 测试儿童肺功能不良是否可以解释极早产 (EP) 出生与青年期注意力缺陷/多动障碍 (ADHD) 症状之间的关系。方法EPICure 出生队列参与者包括 1995 年在英国和爱尔兰出生的妊娠 <26 周的儿童及其足月出生的同学。预测因素是 EP 出生。结果是 19 岁时注意力不集中/多动子量表评分。儿童期和成年早期的用力呼气量 (FEV1)z 分数是中介因素。我们使用递归路径分析来确定 EP 出生对注意力不集中/多动的直接影响及其通过肺功能的间接影响。结果 90 名 EP 和 47 名足月出生的参与者在 11 岁和 19 岁时进行了肺功能测试。 EP 组的注意力不集中得分较高（平均差 0.55 [95% CI 0.11, 0.99]），但多动症得分较高。与足月出生的同龄人相比，EP 参与者的 FEV1z 分数较低，分别为 11（平均差−1.35 [95% CI -1.72, -0.98]）和 19（平均差−1.29 [95% CI -1.65, -0.92]）。路径模型揭示儿童肺功能解释了 EP 出生与注意力不集中之间的关系。 结论 与足月出生的同龄人相比，极早产的年轻人注意力不集中的风险增加。肺功能不良似乎是这种风险的根源。其机制尚不清楚，值得进一步研究。
AimTo test whether poor childhood pulmonary function explains the relationship between extremely preterm (EP) birth and attention‐deficit/hyperactivity disorder (ADHD) symptoms in young adulthood.MethodsEPICure birth cohort participants include children born <26 weeks' gestation in the United Kingdom and Ireland in 1995 and their term‐born classmates. Predictor was EP birth. Outcomes were inattention/hyperactivity subscalez‐scores at 19 years. Forced expiratory volume (FEV1)z‐scores in childhood and young adulthood were mediators. We used recursive path analysis to determine the direct effect of EP birth on inattention/hyperactivity and its indirect effect through pulmonary function.ResultsNinety EP and 47 term‐born participants had pulmonary function testing at 11 and 19 years. Inattentionz‐scores were higher in the EP group (mean difference 0.55 [95% CI 0.11, 0.99]) but not hyperactivity. Compared to term‐born peers, EP participants had lower FEV1z‐scores at 11 (mean difference−1.35 [95% CI −1.72, −0.98]) and 19 (mean difference−1.29 [95% CI −1.65, −0.92]). Path models revealed that childhood pulmonary function explained the relationship between EP birth and inattention.ConclusionsExtremely preterm young adults have increased risk for inattention compared to term‐born peers. Poor pulmonary function appears to underlie this risk. The mechanisms responsible remain unclear and warrant further study.