Childhood neglect and cognitive development in extremely low birth weight infants: a prospective study.
Childhood neglect and cognitive development in extremely low birth weight infants: a prospective study.
复制标题
极低出生体重婴儿的童年忽视和认知发展：一项前瞻性研究。
DOI：
10.1542/peds.108.1.142
复制
发表时间：
2001
期刊：
影响因子：
8
通讯作者：
David O. Wood
中科院分区：
文献类型：
--
作者：
Lane Strathearn;P. Gray;Michael J O'Callaghan;David O. Wood
客观化
研究儿童虐待与极低出生体重儿认知发育的关系，调整围产期和父母的危险因素。
方法
总共对352名出生体重为1000克的婴儿进行了4年的前瞻性跟踪调查。这些数据是关于围产期和父母的风险因素以及向政府机构转介的可疑虐待儿童的。围产期危险因素包括出生体重、孕周、性别、脑室周围出血、脑室扩张、家庭需氧量和坏死性小肠结肠炎。父母的危险因素包括母亲的年龄、种族、婚姻状况、教育程度和医院保险状况。在出生时、2岁和4岁时计算认知z分，在出生时、2岁和4岁时计算头围z分。
结果
15%的婴儿因涉嫌虐待儿童而被转介到儿童保护服务机构。在被转介为忽视的婴儿中，4岁时调整后的一般认知指数显著降低(-17.6；95%可信区间：-3.3，-31.9)。与未被忽视的婴儿(z分数：-0.04至-0.36)相比，忽视被证实的婴儿的认知功能随着时间的推移而逐渐下降(认知z分数分别为-0.97、-1.37和-2.05标准差)。他们在2岁和4岁时的头围明显较小，但在出生时没有(4岁时调整后的z分数：-0.812；95%可信区间：-0.167，-1.458)。围产期危险因素和身体残疾与虐待转诊无关；只有父母因素是独立的预测因素。
结论
儿童时期的忽视与认知发育和头部发育迟缓密切相关。在产前和儿童早期处理风险因素可能会改善结果。
OBJECTIVE
To examine the relationship between child maltreatment and cognitive development in extremely low birth weight infants, adjusting for perinatal and parental risk factors.
METHODS
A total of 352 infants with birth weight of <1000 g were followed prospectively for 4 years. The data were analyzed with regard to perinatal and parental risk factors and referrals for suspected child maltreatment to government agencies. Perinatal risk factors included birth weight, gestation, gender, periventricular hemorrhage, ventricular dilation, home oxygen requirement, and necrotizing enterocolitis. Parental risk factors included maternal age, race, marital status, education, and hospital insurance status. Cognitive z scores were calculated at 1, 2, and 4 years, and head circumference z scores were calculated at birth, 2 years, and 4 years.
RESULTS
Fifteen percent of infants were referred to child protective services for suspected child maltreatment. The adjusted general cognitive index at 4 years was significantly reduced in infants who were referred for neglect (-17.6; 95% confidence interval: -3.3, -31.9). Infants whose neglect was substantiated had a progressive decline in their cognitive function over time (cognitive z scores: -0.97, -1.37, and -2.05 standard deviations at 1, 2, and 4 years, respectively), compared with non-neglected infants (z scores: -0.04 to -0.36). They had a significantly smaller head circumference at 2 and 4 years but not at birth (adjusted z score at 4 years: -0.812; 95% confidence interval: -0.167, -1.458). Perinatal risk factors and physical disability were not related to maltreatment referral; only parental factors were independent predictors.
CONCLUSIONS
Childhood neglect is associated significantly with delayed cognitive development and head growth. Addressing risk factors antenatally and in early childhood may improve outcomes.
登录
查看更多内容
极低出生体重婴儿：婴儿期大脑发育对 3 岁时智商的影响。
影响因子：
8
作者：
Hack,M;Breslau,N
通讯作者：
Breslau,N
安置在滥用药物的母亲身边与安置在其他亲属身边：婴儿结局。
影响因子：
4.8
作者：
Tyler,R;Howard,J;Espinosa,M;Doakes,SS
通讯作者：
Doakes,SS
影响因子：
4.8
作者：
Sullivan, PM;Knutson, JF
通讯作者：
Knutson, JF
影响因子：
8
作者：
Hack, M;Taylor, HG;Mercuri-Minich, N
通讯作者：
Mercuri-Minich, N
婴儿面临双重风险：婴儿的早期发育面临生物和社会风险。
影响因子：
8
作者：
Escalona,SK
通讯作者：
Escalona,SK