Neuropsychological and Behavioral Outcomes of Extremely Low Birth Weight at Age Three
Neuropsychological and Behavioral Outcomes of Extremely Low Birth Weight at Age Three
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DOI：
10.1080/87565641.2011.540526
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发表时间：
2011-01-01
影响因子：
1.5
通讯作者：
Litman, Fern R.
中科院分区：
文献类型：
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作者：
Baron, Ida Sue;Erickson, Kristine;Litman, Fern R.
早产(PT)是导致高死亡率和高发病率的既定危险因素。婴儿和学龄儿童已经得到了很好的研究，但很少有人描述学龄前儿童的神经心理和行为结果。我们比较了2004-2006年早产儿/极低出生体重组(PT/ELBW；N=60)出生33周和3岁时足月出生的参与者(N=90)。早产儿/极低出生体重亚组(26周；26-33周)在语言、非语言、精细运动、视觉运动、视觉注意、名词流利性、早期数字概念和年龄校正前的功能交流措施上的表现比足月出生的组更差；出生26周的PT/ELBW儿童在动作动词流利性方面的表现更差。出生26-33周的婴儿在父母行为报告中存在执行和适应性缺陷。年龄校正显著改善了早产成绩，但没有掩盖可能需要早期干预的相对语言、非语言、运动和行为缺陷。总而言之，在3岁时可以测量到紧急神经心理和行为功能的细微延迟，神经生物学上的不成熟仍然是学龄前儿童结局的主要影响因素。进一步的研究应该会加强我们对这些高危儿童大脑发育轨迹和神经可塑性极限的理解。
Preterm (PT) birth is an established risk factor for high mortality and morbidity rates. Infants and school-aged children have been well-studied, but few have described neuropsychological and behavioral outcomes at preschool age. We compared a 2004-2006 preterm/extremely low birth weight (ELBW) cohort (PT/ELBW; N = 60) born 33 weeks gestation and 1,000 g with term-born participants (N = 90) at age 3. PT/ELBW subgroups (26 weeks; 26-33 weeks) performed more poorly than the term-born group on verbal, nonverbal, fine motor, visual-motor, visual attention, noun fluency, early number concepts, and functional communication measures prior to age correction; PT/ELBW children born 26 weeks additionally performed more poorly on action-verb fluency. Those born 26-33 weeks had executive and adaptive deficits on parental behavioral report. Age correction significantly improved preterm scores without masking relative verbal, nonverbal, motor, and behavioral weaknesses that may require early intervention. In conclusion, subtle delays in emergent neuropsychological and behavioral functions are measurable at age 3, and neurobiological immaturity remains a prepotent influence on outcome in the preschool years. Further study should enhance our understanding of the trajectory of brain development and the limits of neuroplasticity in these highly at-risk children.