Evidence for a Causal Association of Low Birth Weight and Attention Problems
Evidence for a Causal Association of Low Birth Weight and Attention Problems
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DOI：
10.1016/j.jaac.2011.09.007
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发表时间：
2011-12-01
影响因子：
13.3
通讯作者：
Boomsma, Dorret I.
中科院分区：
文献类型：
--
作者：
Groen-Blokhuis, Maria M.;Middeldorp, Christel M.;Boomsma, Dorret I.
目的：低出生体重(LBW)与注意力问题(AP)和注意力缺陷/多动障碍(ADHD)有关。这种关联的病因尚不清楚。我们调查出生体重(BW)是否对AP有因果影响，以及BW效应是否由低体重儿童的追赶生长(CUG)介导。方法：对在荷兰双胞胎登记处登记的29,000对出生体重为1,500 g，胎龄为32周的双胞胎采用双生子对照方法进行分析。在3岁、7岁、10岁和12岁时评估多动症和AP；在出生时和2岁评估体重。结果：体重在1,500~2,000 g之间的儿童在AP上的标准差(SD)比在3,000~3,500 g之间的儿童高0.18~0.37，这种影响存在于足月儿和早产儿中。重要的是，在体重不协调的单合子(MZ)、异卵(DZ)和不相关(UR)配对中，体重较低的儿童在多动和AP上的得分高于体重较高的儿童，在MZ、DZ和UR配对中，配对内差异相似。这一模式与体重对AP的因果效应是一致的。符合LBW但不符合CUG的MZ和DZ双生子的AP得分相似，因此排除了CUG对AP的任何影响。结论：这些结果强烈表明出生体重和AP之间存在因果关系。在LBW儿童中，CUG不能解释体重的影响。J.Am阿卡德。青春期儿童。精神病学，2011；50(12)：1247-1254。
Objective: Low birth weight (LBW) is associated with attention problems (AP) and attention-deficit/hyperactivity disorder (ADHD). The etiology of this association is unclear. We investigate whether there is a causal influence of birth weight (BW) on AP and whether the BW effect is mediated by catch-up growth (CUG) in low-BW children. Method: Longitudinal data front >29,000 twins registered with the Netherlands Twin Register with BW >= 1,500 g and gestational age (GA) >= 32 weeks were analyzed with the cotwin control method. Hyperactivity and AP were assessed at ages 3, 7, 10, and 12 years; weight was assessed at birth and age 2 years. Results: Children in the lowest BW category of 1,500 to 2,000 g scored 0.18 to 0.37 standard deviations (SD) higher on AP than children in the reference category of 3,000 to 3,500 g. This effect was present in term-born and preterm-born children. Importantly, in BW discordant monozygotic (MZ), dizygotic (DZ), and unrelated (UR) pairs, the child with the lower BW scored higher on hyperactivity and AP than the child with the higher BW and within-pair differences were similar for MZ, DZ, and UR pairs. This pattern is consistent with a causal effect of BW on AP. MZ and DZ twin pairs concordant for LBW but discordant for CUG showed similar AP scores, thus ruling out any effect of CUG on AP. Conclusions: These results strongly indicate that the association of birth weight and AP represents a causal relationship. The effects of BW are not explained by CUG in LBW children. J. Am. Acad. Child Adolesc. Psychiatry, 2011;50(12):1247-1254.