Outcomes in young adulthood for very-low-birth-weight infants.
Outcomes in young adulthood for very-low-birth-weight infants.
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DOI：
10.1056/nejm200207113470214
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发表时间：
2002-07
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影响因子：
--
通讯作者：
H. Harrison
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文献类型：
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作者：
H. Harrison
摘要 背景 在新生儿重症监护最初几年出生的极低出生体重婴儿（体重低于 1500 克）现已进入成年早期。方法 我们对 1977 年至 1979 年间出生的 242 名极低出生体重婴儿（平均出生体重 1179 克；出生时平均胎龄 29.7 周）幸存者与来自克利夫兰同一人群的 233 名正常出生体重的对照进行了比较。我们评估了 20 岁时的教育水平、认知和学术成就以及慢性病和冒险行为的发生率。结果根据性别和社会人口状况进行了调整。结果 极低出生体重的年轻人高中毕业率低于正常出生体重的年轻人（74% vs. 83%，P=0.04）。极低出生体重男性（而非女性）参加高等教育研究的可能性显着低于正常出生体重对照（30% vs. 53%，P=0.002）。极低出生体重参与者的平均智商较低（87 vs. 92），学业成绩也较低（两项比较 P<0.001）。他们的神经感觉障碍发生率较高（10% vs. <1%，P<0.001），身高低于正常水平（10% vs. 5%，P=0.04）。与正常出生体重对照组相比，极低出生体重组的饮酒和吸毒情况较少，怀孕率也较低；当比较仅限于没有神经感觉障碍的参与者时，这些差异仍然存在。结论 与极低出生体重相关的教育劣势持续到成年早期。 （新英格兰医学杂志 2002；346：149-57。）
A BSTRACT Background Very-low-birth-weight infants (those weighing less than 1500 g) born during the initial years of neonatal intensive care have now reached young adulthood. Methods We compared a cohort of 242 survivors among very-low-birth-weight infants born between 1977 and 1979 (mean birth weight, 1179 g; mean gestational age at birth, 29.7 weeks) with 233 controls from the same population in Cleveland who had normal birth weights. We assessed the level of education, cognitive and academic achievement, and rates of chronic illness and risk-taking behavior at 20 years of age. Outcomes were adjusted for sex and sociodemographic status. Results Fewer very-low-birth-weight young adults than normal-birth-weight young adults had graduated from high school (74 percent vs. 83 percent, P=0.04). Very-low-birth-weight men, but not women, were significantly less likely than normal-birth-weight controls to be enrolled in postsecondary study (30 percent vs. 53 percent, P=0.002). Very-low-birth-weight participants had a lower mean IQ (87 vs. 92) and lower academic achievement scores (P<0.001 for both comparisons). They had higher rates of neurosensory impairments (10 percent vs. <1 percent, P<0.001) and subnormal height (10 percent vs. 5 percent, P=0.04). The very-low-birth-weight group reported less alcohol and drug use and had lower rates of pregnancy than normal-birth-weight controls; these differences persisted when comparisons were restricted to the participants without neurosensory impairment. Conclusions Educational disadvantage associated with very low birth weight persists into early adulthood. (N Engl J Med 2002;346:149-57.)