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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Childhood neglect and cognitive development in extremely low birth weight infants: a prospective study.
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Childhood neglect and cognitive development in extremely low birth weight infants: a prospective study.

机译：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。

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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.
机译：目的：探讨儿童虐待与极低出生体重婴儿认知发展之间的关系，并调整围产期和父母的危险因素。方法：对352例出生体重<1000 g的婴儿进行了为期4年的前瞻性随访。分析了围产期和父母的危险因素以及将可疑儿童虐待转介给政府机构的数据。围产期的危险因素包括出生体重，妊娠，性别，脑室出血，心室扩张，家庭需氧量和坏死性小肠结肠炎。父母的危险因素包括产妇年龄，种族，婚姻状况，教育程度和医院保险状况。分别在1、2和4岁时计算认知z得分，在出生，2岁和4岁时计算头围z得分。结果：15％的婴儿因涉嫌虐待儿童而被转送到儿童保护服务机构。被忽视的婴儿在4岁时调整后的一般认知指数显着降低（-17.6; 95％置信区间：-3.3，-31.9）。与未被忽视的婴儿相比，被忽视的婴儿的认知功能随着时间的推移逐渐下降（认知z评分：分别在1、2和4岁时为-0.97，-1.37和-2.05标准差）（ z分数：-0.04至-0.36）。他们在2岁和4岁时的头围明显较小，但在出生时却没有（4岁时调整后的z得分：-0.812; 95％置信区间：-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：儿童期的忽视与认知发育延迟和头部生长显着相关。在产前和儿童早期解决危险因素可能会改善结局。

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