Mental health at 5 years among children born extremely preterm: a national population-based study
Mental health at 5 years among children born extremely preterm: a national population-based study
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DOI：
10.1007/s00787-012-0298-1
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发表时间：
2012-10-01
影响因子：
6.4
通讯作者：
Markestad, Trond
中科院分区：
文献类型：
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作者：
Elgen, Silje Katrine;Leversen, Katrine Tyborg;Markestad, Trond
本研究的目的是比较5岁时极度早产儿童与参照组的心理健康状况，并评估早产儿组的功能能力和心理健康之间的关系。在一个胎龄22-27周或出生体重500-999 g的挪威国家队列中，使用优势和困难问卷（SDQ）评估心理健康，使用韦氏学前和初级智力量表（WPPSI-R）评估认知功能，使用儿童运动评估量表（ABC-test）评估运动功能，使用大运动功能分类（GMFCS）评估脑瘫（CP）的严重程度。神经发育障碍（NDD）分为轻度和中度/重度。将早产儿的SDQ与未选择的参照组进行比较。参考组的SDQ分值为每千分之一日元的第90个百分位数被定义为精神健康问题，而总困难分值为每千分之一日元的第90个百分位数（TDS90）被定义为精神障碍的暗示。在361名符合条件的早产儿中，有255名（71%）的父母完成了SDQ。97例（38%）TDS90，而对照组116例（11%）TDS90 （OR 5.1; 95% CI 3.7-7.1）。对于早产儿，中度/重度NDD患者的TDS90率更高（27/37 vs. 27/116，校正OR 8.0; 95% CI 3.2-19），轻度NDD患者的TDS90率为43/102[校正OR 2.2(1.2-4.1)]。对于没有NDD的早产儿，TDS90比对照组更常见（27/116比116/1,089,OR 2.5; 95% CI 1.6-4.1）。极度早产与后期心理健康问题的风险增加有关，特别是如果他们有其他功能障碍。
The objective of this study was to compare mental health at 5 years in children born extremely preterm with a reference group, and assess associations between functional abilities and mental health within the preterm group. In a national Norwegian cohort with gestational age 22-27 weeks or birthweight 500-999 g, mental health was assessed with the Strengths and Difficulties Questionnaire (SDQ), cognitive function with the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R), motor function with the Movement Assessment Battery for children (ABC-test) and severity of cerebral palsy (CP) with the Gross Motor Function Classification for CP (GMFCS). Neurodevelopmental disabilities (NDD) were described as mild and moderate/severe. SDQ of the preterm children was compared with that of an unselected reference group. SDQ sub-scores a parts per thousand yen90th percentile of the reference group were defined as a mental health problem and a Total Difficulties Score a parts per thousand yen90th percentile (TDS90) as suggestive of psychiatric disorder. Of 361 eligible preterm children, parents completed SDQ for 255 (71 %). 97 (38 %) had TDS90 compared to 116 (11 %) of the reference group (OR 5.1; 95 % CI 3.7-7.1). For the preterms, the rate of TDS90 was higher for those with moderate/severe NDD (27/37 vs. 27/116, adjusted OR 8.0; 95 % CI 3.2-19, and mild NDD 43/102 [adjusted OR 2.2 (1.2-4.1)]. For preterms with no NDD, TDS90 was more common than for the reference group (27/116 vs. 116/1,089, OR 2.5; 95 % CI 1.6-4.1). Extreme prematurity was associated with increased risk of later mental health problems, particularly if they had other functional impairments.