LONG-TERM DEVELOPMENTAL OUTCOMES OF LOW-BIRTH-WEIGHT INFANTS
LONG-TERM DEVELOPMENTAL OUTCOMES OF LOW-BIRTH-WEIGHT INFANTS
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DOI：
10.2307/1602514
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发表时间：
1995-03-01
影响因子：
--
通讯作者：
TAYLOR, HG
中科院分区：
文献类型：
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作者：
HACK, M;KLEIN, NK;TAYLOR, HG
新生儿医学的进步提高了出生体重越来越低的婴儿的存活率。虽然这些医学上的成功案例凸显了医疗技术在挽救许多出生时最小婴儿的力量，但这些婴儿将如何发育以及他们是否会有正常的、有意义的生活，仍然存在严重的问题。低出生体重儿童可能在足月或足月前出生，并有不同程度的社会和医疗风险。由于低出生体重儿童不是一个同质的群体，他们有广泛的生长，健康和发育结果。虽然绝大多数低出生体重儿童的结局正常，但作为一个群体，他们通常有更高的发育不良，疾病和神经发育问题的发生率。这些问题随着孩子出生体重的下降而增加。除了少数患有智力迟钝和/或脑瘫的低出生体重儿外，大多数低出生体重儿的发育后遗症包括认知、注意力和神经运动功能方面的轻度问题。对20世纪60年代出生的儿童进行的长期随访研究表明，出生时低出生体重的不良后果在青春期仍然很明显，不良的社会人口因素对低出生体重连续体的发育结果产生负面影响，对长期认知结果的影响似乎比大多数生物风险因素大得多。此外，随着儿童年龄的增长，与社会或环境风险相关的认知缺陷变得更加明显。低出生体重儿的营养强化计划似乎对来自较低社会经济群体的中度低出生体重儿最为有效。继续研究和尝试降低低出生体重儿的发生率和相关的围产期医学后遗症至关重要。需要强制要求持续记录低出生体重儿童的长期结果，实施环境丰富计划以帮助改善低出生体重婴儿的长期后果。
Advances in neonatal medicine have resulted in the increased survival of infants at lower and lower birth weight. While these medical success stories highlight the power of medical technology to save many of the tiniest infants at birth, serious questions remain about how these infants will develop and whether they will have normal, productive lives.Low birth weight children can be born at term or before term and have varying degrees of social and medical risk. Because low birth weight children are not a homogeneous group, they have a broad spectrum of growth, health, and developmental outcomes. While the vast majority of low birth weight children have normal outcomes, as a group they generally have higher rates of subnormal growth, illnesses, and neurodevelopmental problems. These problems increase as the child's birth weight decreases. With the exception of a small minority of low birth weight children with mental retardation and/or cerebral palsy, the developmental sequelae for most low birth weight infants include mild problems in cognition, attention, and neuromotor functioning. Long-term follow-up studies conducted on children born in the 1960s indicated that the adverse consequences of being born low birth weight were still apparent in adolescence.Adverse sociodemographic factors negatively affect developmental outcomes across the continuum of low birth weight and appear to have far greater effects on long-term cognitive outcomes than most of the biological risk factors. In addition, the cognitive defects associated with social or environmental risks become more pronounced as the child ages. Enrichment programs for low birth weight children seem to be most effective for the moderately low birth weight child who comes from a lower socioeconomic group.Continued research and attempts to decrease the rate of low birth weight and associated perinatal medical sequelae are of primary importance. Ongoing documentation of the long-term outcome of low birth weight children needs to be mandated, as does the implementation of environmental enrichment programs to help ameliorate the long-term consequences for infants who are born low birth weight.