过早出生的学龄儿童的认知和行为结果:一个元分析
Adnan T Bhutta1, Mario A Cleves, Patrick H Casey
1Department of Pediatrics, Arkansas University for Medical Sciences, Little Rock, USA.
JAMA
|August 10, 2002
概括
过早出生的孩子面临着较低认知分数和增加行为问题的风险,包括注意力缺陷/多动症障碍 (ADHD). 这些结果与早产有关,认知功能与出生体重和妊娠年龄成正比.
科学领域:
- 发育儿科 发育儿科
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
背景情况:
- 对早产的学龄儿童进行了广泛的研究,但许多研究存在方法上的缺陷.
- 由于这些局限性,对早产的长期结果的准确估计具有挑战性.
研究的目的:
- 系统地估计早产对学龄儿童认知和行为结果的影响.
- 分析早产和认知发育之间的关系.
主要方法:
- 一个全面的MEDLINE和手动搜索 (1980-2001) 确定了相关的病例控制研究.
- 包括的研究评估了5岁生日后的儿童<30%的磨损;15个是认知,16个是行为.
- 超分析回归模型评估了出生体重和妊娠年龄的影响; 聚合相对风险 (RRs) 计算了ADHD发病率.
主要成果:
- 与对照组相比,早产儿的认知分数明显较低 (平均差异为10.9).
- 认知分数与出生体重 (R2=0.51) 和妊娠年龄 (R2=0.49) 直接成比例.
- 过早出生的孩子表现出更多的外化/内化行为 (81%的研究) 和2.64倍的ADHD风险增加.
结论:
- 过早出生的孩子面临认知测试得分下降的风险,出生时的不成熟与学龄认知功能相关.
- 过早分娩与较高的注意力缺陷/多动症障碍 (ADHD) 和其他行为问题发生率有关.
- 研究质量没有显著影响观察到的认知或行为结果.
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