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首页> 外文期刊>Journal of child psychology and psychiatry >Neonatal cerebral morphometry and later risk of persistent inattention/hyperactivity in children born very preterm
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Neonatal cerebral morphometry and later risk of persistent inattention/hyperactivity in children born very preterm

机译：早产儿的新生儿脑形态计量学和后来出现持续注意力不集中/多动的风险

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Background Attention problems are among the most prevalent neurobehavioral morbidities affecting very preterm (VPT) born children. The first study aim was to document rates of persistent attention/hyperactivity problems from ages 4 to 9 years in a regional cohort of VPT born children. The second aim was to examine the extent to which persistent problems were related to cerebral white matter abnormality and structural development on neonatal MRI. Methods Data were drawn from a prospective longitudinal study of 110 VPT (≤32 weeks gestation) and 113 full-term (FT) children born from 1998 to 2000. At term equivalent, all VPT and 10 FT children underwent cerebral structural MRI, with scans analyzed qualitatively for white matter abnormalities and quantitatively for cortical and subcortical gray matter, myelinated and unmyelinated white matter, and cerebrospinal fluid volumes. At ages 4, 6, and 9 years, each child's parent and teacher completed the Inattention/Hyperactivity subscale of the Strengths and Difficulties Questionnaire. Results VPT born children had a fivefold increased risk of persistent attention/hyperactivity problems compared with FT children (13.1% vs. 2.8%; p =.002). No association was found between neonatal white matter abnormalities and later persistent inattention/hyperactivity risk (p ≥.24). In contrast, measures of cerebral structural development including volumetric estimates of total cerebral tissue and cerebrospinal fluid relative to intracranial volume were associated with an increased risk of persistent attention/hyperactivity problems in VPT born children (p =.001). The dorsal prefrontal region showed the largest volumetric reduction (↓3.2-8.2 mL). These brain-behavior associations persisted and in some cases, strengthened after covariate adjustment for postmenstrual age at MRI, gender, and family socioeconomic status. Conclusions Just over one in 10 VPT born children are subject to early onset and persistent attention/hyperactivity problems during childhood. These problems appear to reflect, at least in part, neonatal disturbances in cerebral growth and development rather than the effects of white matter injury.
机译：背景技术注意问题是影响极早产（VPT）出生儿童的最普遍的神经行为病态。第一项研究的目的是记录在VPT出生儿童的区域队列中4到9岁之间持续关注/多动问题的发生率。第二个目标是检查新生儿MRI上与脑白质异常和结构发育有关的持续性问题的程度。方法数据来自于1998年至2000年出生的110名VPT（≤32周妊娠）和113名足月（FT）儿童的前瞻性纵向研究。在同等学历下，所有VPT和10名FT儿童均接受了脑结构MRI扫描定性分析白质异常，定量分析皮层和皮层下灰质，髓质和非髓质白质以及脑脊液量。在4、6和9岁时，每个孩子的父母和老师都要完成“长处和困难问卷”中的“注意力不集中/多动症”子量表。结果与FT儿童相比，VPT出生儿童的持续注意力/多动症风险增加了五倍（13.1％比2.8％; p = .002）。新生儿白质异常与以后持续的注意力不集中/多动症风险之间没有关联（p≥.24）。相反，脑结构发育的测量，包括相对于颅内容积的总脑组织和脑脊髓液的体积估计，与VPT出生的儿童持续注意力/多动问题的风险增加相关（p = .001）。背前额叶区域显示最大的体积减少（↓3.2-8.2 mL）。在对MRI，性别和家庭社会经济状况的经后年龄进行协变量调整后，这些脑行为关联持续存在，并且在某些情况下得到增强。结论十分之一的VPT出生的儿童在儿童时期会出现早期发作和持续的注意力/多动问题。这些问题似乎至少部分反映了新生儿大脑生长发育障碍，而不是白质损伤的影响。

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