Variation in Child Cognitive Ability by Week of Gestation Among Healthy Term Births
Variation in Child Cognitive Ability by Week of Gestation Among Healthy Term Births
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DOI：
10.1093/aje/kwp413
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发表时间：
2010-02-15
影响因子：
5
通讯作者：
Kramer, Michael S.
中科院分区：
文献类型：
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作者：
Yang, Seungmi;Platt, Robert W.;Kramer, Michael S.
作者使用1996-1997年在白俄罗斯招募的前瞻性队列数据，调查了13,824名6岁半正常体重足月出生儿童的认知能力随胎龄的变化。在控制母亲和家庭特征后，通过完整周内的胎龄和胎儿生长检查韦氏简明智力量表的平均差异。与39-41周出生的儿童相比，在控制混杂因素后，37周出生的儿童的全量表智商（IQ）评分低1.7分（95%置信区间（CI）：-2.7，-0.7），38周出生的儿童的全量表IQ评分低0.4分（95% CI：-1.1，0.02）。过期儿童也存在分级关系：42周时评分低0.5分（95% CI：-2.6，1.6），43周时评分低6.0分（95% CI：-15.1，3.1）。与大于胎龄儿（>第90百分位数）相比，小于胎龄儿（<第10百分位数）的智商最低，其次是第10 - 50百分位数和>第50 - 90百分位数。这些研究结果表明，即使在足月出生的健康儿童中，在37或38周出生的儿童和胎儿发育不佳的儿童在6.5岁时的认知能力也较低。
The authors investigated variations in cognitive ability by gestational age among 13,824 children at age 6.5 years who were born at term with normal weight, using data from a prospective cohort recruited in 1996-1997 in Belarus. The mean differences in the Wechsler Abbreviated Scales of Intelligence were examined by gestational age in completed weeks and by fetal growth after controlling for maternal and family characteristics. Compared with the score for those born at 39-41 weeks, the full-scale intelligence quotient (IQ) score was 1.7 points (95% confidence interval (CI): -2.7, -0.7) lower in children born at 37 weeks and 0.4 points (95% CI: -1.1, 0.02) lower at 38 weeks after controlling for confounders. There was also a graded relation in postterm children: a 0.5-points (95% CI: -2.6, 1.6) lower score at 42 weeks and 6.0 points (95% CI: -15.1, 3.1) lower at 43 weeks. Compared with children born large for gestational age (> 90th percentile), children born small for gestational age (< 10th percentile) had the lowest IQ, followed by those at the 10th-50th percentile and those at the > 50th-90th percentile. These findings suggest that, even among healthy children born at term, cognitive ability at age 6.5 years is lower in those born at 37 or 38 weeks and those with suboptimal fetal growth.