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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Lasting effects of preterm birth and neonatal brain hemorrhage at 12 years of age.
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Lasting effects of preterm birth and neonatal brain hemorrhage at 12 years of age.

机译：12岁时早产和新生儿脑出血的持久影响。

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OBJECTIVES: Our goals were to compare cognitive, language, behavioral, and educational outcomes of preterm children to term controls and to evaluate the impact of neonatal brain injury, indomethacin, and environmental risk factors on intellectual function at 12 years of age. METHODS: A total of 375 children born in 1989-1992 with birth weights of 600 to 1250 g enrolled in the Indomethacin Intraventricular Hemorrhage Prevention Trial and 111 controls were evaluated. Neuropsychometric testing, neurologic examination, and interviews on educational needs were completed. Severe brain injury was defined as the presence of grade 3 to 4 indomethacin intraventricular hemorrhage, periventricular leukomalacia, or severe ventriculomegaly on cranial ultrasound. RESULTS: On the Wechsler Scales of Intelligence for Children, the preterm cohort obtained a full-scale IQ of 87.9 +/- 18.3, verbal IQ of 90.8 +/- 18.9, and performance IQ of 86.8 +/- 17.9. Preterm children obtained scores 6 to 14 points lower than term controls on all psychometric tests after adjustment for sociodemographic factors. On the Clinical Evaluation of Language Fundamentals (test of basic language skills), 22% to 24% of preterm children scored in the abnormal ranges (<70) as opposed to 2% to 4% of controls. Preterm children with and without brain injury required more school services (76% and 44% vs 16%), and support in reading (44% and 28% vs 9%), writing (44% and 20% vs 4%), and mathematics (47% and 30% vs 6%) compared with controls. Preterm children also displayed more behavior problems than their term counterparts. Severe neonatal brain injury was the strongest predictor of poor intelligence. Antenatal steroids, higher maternal education, and 2-parent family were associated with better cognition, whereas minority status incurred a disadvantage. Indomethacin did not affect intellectual function among preterm children. CONCLUSIONS: Preterm children born in the early 1990s, especially those with severe brain injury, demonstrate serious deficits in their neuropsychological profile, which translates into increased use of school services at 12 years.
机译：目的：我们的目标是比较早产儿与足月对照的认知，语言，行为和教育成果，并评估新生儿脑损伤，消炎痛和环境危险因素对12岁时智力功能的影响。方法：对1989-1992年出生的375例出生体重在600至1250g之间的儿童进行了吲哚美辛脑室内出血预防试验和111例对照的评估。神经心理测验，神经系统检查和有关教育需求的访谈已完成。严重的脑损伤定义为存在3至4级消炎痛脑室内出血，脑室白细胞软化或颅脑超声检查发现严重的脑室肥大。结果：在韦氏儿童智力量表上，早产儿的智商为87.9 +/- 18.3，言语智商为90.8 +/- 18.9，表现智商为86.8 +/- 17.9。在调整了社会人口统计学因素后，所有心理测试的早产儿得分均比足月对照组低6至14分。在语言基础知识的临床评估（基本语言技能测试）中，早产儿的22％至24％得分在异常范围内（<70），而对照组则为2％至4％。有或没有脑损伤的早产儿需要更多的学校服务（分别为76％和44％对16％），阅读方面的支持（44％和28％对9％），写作方面的支持（44％和20％对4％），以及数学（分别为47％和30％与6％）相比。早产儿也比其早产儿表现出更多的行为问题。严重的新生儿脑损伤是智力低下的最强预测因子。产前类固醇，较高的母亲教育水平和2个父母家庭与更好的认知能力有关，而少数群体地位则处于不利地位。消炎痛不影响早产儿的智力功能。结论：1990年代初出生的早产儿，特别是患有严重脑损伤的早产儿，其神经心理特征严重不足，这意味着12岁时对学校服务的使用增加。

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