Preterm Birth, Poverty, and Cognitive Development
Preterm Birth, Poverty, and Cognitive Development
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DOI：
10.1542/peds.2017-0509
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发表时间：
2018-01-01
期刊：
影响因子：
8
通讯作者：
Kramer, Michael R.
中科院分区：
文献类型：
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作者：
Beauregard, Jennifer L.;Drews-Botsch, Carolyn;Kramer, Michael R.
背景：早产和儿童贫困都会对儿童的认知发展和学业成绩产生不利影响。在这项研究中，我们调查了早产和早产与儿童在3岁、5岁和7岁时的认知得分之间的关系是否受到童年贫困的影响。方法：本研究采用英国千禧年队列研究中妊娠24至40周出生的单胎数据进行。使用线性回归模型来测试胎龄（早期或中度早产、晚期早产或早产与足月相比）和儿童贫困（<英国收入中位数的60%）与儿童认知得分的独立和联合关联。利用相互作用项检验胎龄与贫困之间存在加性相互作用。结果：早产（< 37周）或足月早期（37-38周）的儿童在认知评估中的得分往往比足月（39-40周）出生的儿童更差。与足月相比，早期或中度早产的估计缺陷为0.2至0.3 SD，晚期早产的估计缺陷为0.1 SD，早期早产的估计缺陷为0.05 SD。在所有评估中，生活在贫困中的儿童比没有生活在贫困中的儿童得分低0.3至0.4个标准差。对于大多数评估，估计这两个因素的影响大约是相加的，很少或没有证据表明胎龄和贫困之间存在相互作用。结论：虽然生活贫困的早产儿认知结局最差，但生活贫困并没有放大早产对认知发展的不利影响。
BACKGROUND: Preterm birth and childhood poverty each adversely impact children's cognitive development and academic outcomes. In this study, we investigated whether the relationships between preterm and early term birth and children's cognitive scores at 3, 5, and 7 years old were modified by childhood poverty.METHODS: This study was conducted by using data on singletons born at 24 to 40 weeks' gestation enrolled in the Millennium Cohort Study in the United Kingdom. Linear regression models were used to test independent and joint associations of gestational age (early or moderate preterm, late preterm, or early term compared with term) and childhood poverty (< 60% of median UK income) with children's cognitive scores. Presence of additive interaction between gestational age and poverty was tested by using interaction terms.RESULTS: Children born preterm (< 37 weeks) or early term (37-38 weeks) tended to score more poorly on cognitive assessments than children born at term (39-40 weeks). The estimated deficits were similar to 0.2 to 0.3 SD for early or moderate preterm, 0.1 SD for late preterm, and 0.05 SD for early term compared with term. Children living in poverty scored 0.3 to 0.4 SD worse than children not living in poverty on all assessments. For most assessments, the estimated effects of the 2 factors were approximately additive, with little or no evidence of interaction between gestational age and poverty.CONCLUSIONS: Although children born preterm who lived in poverty had the poorest cognitive outcomes, living in poverty did not magnify the adverse effect of being preterm on cognitive development.