摘要
Background: Many children born very preterm have cognitive and minor motor pro blems later, even if attending mainstream schools. Objective: To examine associa tions between this suboptimal performance and perinatal and postnatal clinical f actors. Participants and methods: A geographically determined cohort of 280 infa nts born at less than 32 weeks gestation in 1991-92 in Liverpool, free of major disability and attending mainstream school at 7 years of age. A perinatal and p ostnatal data set were obtained from the clinical records retrospectively. Measu rements of height, weight, and head circumference at 7 years were made, together with assessments of intelligence (Wechsler intelligence scale for children, IQ) and motor impairment (Movement assessment battery for children, MABC). Results: Multiple regression analysis showed IQ at 7 years to be independently significa ntly related to gestation, persistence of the arterial duct (PDA), and head circ umference at 7 years. MABC was only significantly related to gestation. PDA was related to periventricular haemorrhage (OR 2.7, 95%confidence interval (CI) 1 .3 to 5.8) and parenchymal lesions including ventriculomegaly (OR 4.1, 95%CI 1.5 to 11.4). Conclusion: Cognitive ability in children born pretermis signif icantly related to gestation, but may also be related to the effects of PDA on e arly brain development, through either periventricular haemorrhage/ ventriculome galy or other disturbance of early brain growth.
Background: Many children born very preterm have cognitive and minor motor pro blems later, even if attending mainstream schools. Objective: To examine associa tions between this suboptimal performance and perinatal and postnatal clinical f actors. Participants and methods: A geographically determined cohort of 280 infa nts born at less than 32 weeks gestation in 1991-92 in Liverpool, free of major disability and attending mainstream school at 7 years of age. A perinatal and p ostnatal data set were obtained from the clinical records retrospectively. Measu rements of height, weight, and head circumference at 7 years were made, together with assessments of intelligence (Wechsler intelligence scale for children, IQ) and motor impairment (Movement assessment battery for children, MABC). Results: Multiple regression analysis showed IQ at 7 years to be independently significa ntly related to gestation, persistence of the arterial duct (PDA), and head circ umference at 7 years. MABC was only significantly related to gestation. PDA was related to periventricular haemorrhage (OR 2.7, 95%confidence interval (CI) 1 .3 to 5.8) and parenchymal lesions including ventriculomegaly (OR 4.1, 95%CI 1.5 to 11.4). Conclusion: Cognitive ability in children born pretermis signif icantly related to gestation, but may also be related to the effects of PDA on e arly brain development, through either periventricular haemorrhage/ ventriculome galy or other disturbance of early brain growth.
