Resilience in Extremely Preterm/Extremely Low Birth Weight Kindergarten Children.
Resilience in Extremely Preterm/Extremely Low Birth Weight Kindergarten Children.
复制标题
极早产/极低出生体重幼儿园儿童的适应力。
DOI：
10.1017/s1355617719000080
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Klein,Nancy
中科院分区：
文献类型：
--
作者：
Taylor,HGerry;Minich,Nori;Schluchter,Mark;Espy,KimberlyAndrews;Klein,Nancy
早产的发育结果的研究传统上集中在不良影响。本研究调查了146名极早产/极低出生体重（EPT/ELBW）儿童（胎龄<28周和/或出生体重<1000 g）在幼儿园和111名足月出生正常出生体重（NBW）对照中的韧性的患病率和相关性。EPT/ELBW组中的“恢复力”）的定义是成绩测试的分数在年级期望范围内，并且没有临床上升高的父母对儿童行为问题的评分。符合这些标准的“适应性”儿童与不符合儿童和家庭特征的“适应不良”儿童进行比较。进行了额外的分析，以评估群体（ELBW与NBW）和家庭因素对适应能力的联合影响。结果EPT/ELBW组中有相当一部分（45%）有能力，而大多数NBW对照组（73%），比值比（95%置信区间）=0.26（0.15，0.45），p<0.001。在两组中，适应能力与较高的认知技能、更有利的行为和学习评级（不用于定义适应能力）、更舒适的家庭环境以及EPT/ELBW组中较低的早期神经发育障碍率相关。较高的社会经济地位和更有利的近端家庭环境与独立于组的能力，并在未来两个schoolyears.ConclusionsThe研究结果文件的能力在幼儿园极端早产儿和突出的环境因素的作用，作为潜在的影响结果。(JINS，2019，25，362-374）
ObjectivesResearch on developmental outcomes of preterm birth has traditionally focused on adverse effects. This study investigated the prevalence and correlates of resilience in 146 extremely preterm/extremely low birth weight (EPT/ELBW) children (gestational age <28 weeks and/or birth weight <1000 g) attending kindergarten and 111 term-born normal birth weight (NBW) controls.MethodsAdaptive competence (i.e., “resilience” in the EPT/ELBW group) was defined by scores within grade expectations on achievement tests and the absence of clinically elevated parent ratings of child behavior problems. The “adaptive” children who met these criteria were compared to the “maladaptive” children who did not on child and family characteristics. Additional analyses were conducted to assess the conjoint effects of group (ELBW vs. NBW) and family factors on adaptive competence.ResultsA substantial minority of the EPT/ELBW group (45%) were competent compared to a majority of NBW controls (73%), odds ratio (95% confidence interval)=0.26 (0.15, 0.45), p<.001. Adaptive competence was associated with higher cognitive skills, more favorable ratings of behavior and learning not used to define adaptive competence, and more advantaged family environments in both groups, as well as with a lower rate of earlier neurodevelopmental impairment in the EPT/ELBW group. Higher socioeconomic status and more favorable proximal home environments were associated with competence independent of group, and group differences in competence persisted across the next two school years.ConclusionsThe findings document resilience in kindergarten children with extreme prematurity and highlight the role of environmental factors as potential influences on outcome. (JINS, 2019, 25, 362–374)