摘要
研究背景:小于胎龄(SGA)超低出生体重(ELBW)儿,通常比较矮小,或学习能力低下,或两种现象同时存在。适宜胎龄(AGA)的双胞胎或三胞胎儿童中,出生体重较小的儿童也可发生类似的问题。目的:评价小于胎龄的超低出生体重(SGAELBW)
Background: Small for gestational age (SGA) extremely low birthweight (ELBW < 1000 g) survivors often remain small and/or have subnormal school performance. Some are twins/triplets with larger appropriate size for gestational age (AGA) co-twins/triplets. Objective: To assess whether SGA ELBW twins/triplets remain different from their AGA co-twins/ triplets. Design, setting: During 1981 - 1999, 353 SGAELBW neonates were admitted to our neonatal intensive care unit: 267 survived, 54/267 were twins/triplets, and 36/54 had AGA surviving co-twins/triplets. This longitudinal study describes the growth, neurodevelopmental outcome, and school performance of these 36 sets (3-17 years). The children were classified as normal, or having minor, moderate, or severe deficiencies. Results: Values for birth weight (mean in-trapair z score difference 2. 26), length (2. 74), and head circumference (2. 62) were lower in SGA neonates than in AGA co-twins/triplets. SGA survivors remained smaller at 3-6 years of age: mean intrapair z score difference in weight, 1. 37, height, 1. 54, head circumference, 1. 21. From 6 to 17 years, smaller differences persisted. Former SGA children had a tendency to havemotor deficiencies (nine SGA v three AGA) and mental retardation (seven v four), same hearing loss (two v two), but significantly more visual abnormalities (15 v 11), behavioural disturbances (14 v five), and speech problems (14 v eight) . Twenty four sets were in the same normal level class, often supported by familial/professional help. Conclusions: Although raised in the same environment, SGA ELBW survivors remained smaller and had more visual/behavioural/ speech problems, but most maintained grade level parity with their AGA siblings, with appropriate help.
