早期出産した学齢期の子供の認知および行動的結果:メタ分析
Adnan T Bhutta1, Mario A Cleves, Patrick H Casey
1Department of Pediatrics, Arkansas University for Medical Sciences, Little Rock, USA.
JAMA
|August 10, 2002
まとめ
時期尚早に生まれた子供は,認知スコアが低下し,注意欠陥/多動性障害 (ADHD) を含む行動障害が増加するリスクに直面します. これらの結果は早産と関連しており,認知機能は出生体重と妊娠年齢に正比例しています.
科学分野:
- 発達小児科 発達小児科
- 神経科学は神経科学である.
- 公衆衛生は公衆衛生である.
背景:
- 学校に通う年齢の早産児については,広範な研究が行われているが,多くの研究には方法論的な欠陥がある.
- これらの制限のために,早産の長期的な結果の正確な推定は困難です.
研究 の 目的:
- 学校年齢の子供の認知および行動上の結果に対する早産の影響を体系的に推定する.
- 幼児の早産と認知発達との関係を分析する.
主な方法:
- 総合的なMEDLINEと手動検索 (1980-2001) によって,関連するケース・コントロール研究が特定されました.
- 含まれている研究では,5歳の誕生日を経った子どもを評価し,30%未満の消耗率; 認知15%,行動16%でした.
- メタアナリシス回帰モデルでは,出生体重と妊娠年齢の影響を評価し,ADHDの発生率で計算された相対リスク (RRs) をまとめました.
主要な成果:
- 時期尚早に生まれた子どもは,対照群と比較して認知スコアが著しく低い (平均差10.9) でした.
- 認知スコアは出生体重 (R2=0.51) と妊娠年齢 (R2=0.49) と正比であった.
- 胎児は,外部化/内部化行動 (81%の研究) が増加し,ADHDのリスクが2.64倍増加しました.
結論:
- 時期尚早に生まれた子供は,認知テストのスコアが低下するリスクがあり,出生時の不成熟は,学齢期の認知機能と相関しています.
- 胎児の早産は,注意欠陥/多動性障害 (ADHD) およびその他の行動障害の発生率が高いことと関連しています.
- 研究の質は,観察された認知的または行動的結果に有意な影響を及ぼさなかった.
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