Neurologic soft signs and low birthweight: Their association and neuropsychiatric implications
Neurologic soft signs and low birthweight: Their association and neuropsychiatric implications
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DOI：
10.1016/s0006-3223(99)00131-6
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发表时间：
2000-01-01
影响因子：
10.6
通讯作者：
Lucia, VC
中科院分区：
文献类型：
--
作者：
Breslau, N;Chilcoat, HD;Lucia, VC
背景：我们研究了低出生体重（LBW）和正常出生体重（NBW）儿童的神经软体征与认知缺陷、学习障碍和精神问题之间的关系。方法：从密歇根州两家主要医院1983-1985年新生儿出院病例中选择LEW和NEW儿童的代表性样本，在6岁和11岁时评估823名儿童（占目标样本的75%）。采用标准化的神经系统评估方法测量6岁儿童的神经系统软体征（排除有明显神经功能障碍的儿童），采用WISC-R测量Ie，由母亲和教师评定行为问题清单，采用标准学业成绩测试来识别学习障碍，所有评估均不考虑LEW状态，采用多元回归分析，应用广义估计方程（GEE），我们根据来自多个被调查者和评估次数的信息，估计了软信号对3个行为领域的影响。结果：LEW与软体征的风险增加两倍相关，软体征增加智商正常儿童低水平和学习障碍的风险，软体征与LEW和新儿童过度的内化问题有关，与LEW儿童的注意和外化问题有关；LEW儿童的外化问题过多仅在6岁时被观察到。结论：软迹象是认知和精神问题的高风险标志，特别值得关注的是它们在LEW儿童中的存在，在这些儿童中，它们与更严重的认知缺陷和更普遍的精神问题有关。
Background: We examine the relationship between neurologic soft signs and cognitive deficits, learning disorders, and psychiatric problems in low birthweight (LBW) and normal birthweight (NBW) children,Methods: Representative samples of LEW and NEW children were selected from the 1983-1985 newborn discharges of two major hospitals in Michigan, Eight hundred-twenty three children (75% of the target sample) were evaluated at ages 6 and 11. A standardized neurologic evaluation was used by neurologists to measure neurologic soft signs at age 6 (children with frank neurologic impairment were excluded), Ie was measured by WISC-R and behavior problem lists were rated by mothers and teachers, Standard tests of academic achievement were used to identify learning disorders, All assessments were blind to LEW status, Using multiple regression analysis, applying generalized estimating equations (GEE), we estimated the effects of soft signs on 3 behavioral domains, based on information from multiple informants and times of assessment.Results: LEW was associated with a two-fold increased risk for soft signs, Soft signs increased the risk for subnormal le and for learning disorders in children with normal IQ Soft signs were associated with excess internalizing problems in LEW and NEW children, and with attention and externalizing problems in LEW children; the excess in externalizing problems in LEW children was observed only at age 6.Conclusions: Soft signs are a marker of high risk for cognitive and psychiatric problems, Of particular concern is their presence in LEW children, in whom they are associated with more severe cognitive deficits and more pervasive psychiatric problems.