Abstract：
BACKGROUND: The literature on cognitive and academic outcomes for children with sickle cell disease (SCD) who experience perinatal risk factors is limited. We aimed to evaluate if low birthweight (LBW), gestational age, and history of neonatal intensive care unit (NICU) admission were associated with neurocognitive functioning, grade retention, or receipt of early intervention or formal educational support in children with SCD.
METHODS: This prospective birth cohort study included 336 participants, ages 8-18, with SCD, who received cognitive testing as part of standard of care and whose caregivers completed behavioral rating scales. Multivariable generalized linear regression models were used to examine associations between perinatal risks and outcome variables, after adjusting for demographic and medical covariates.
RESULTS: The prevalence of NICU admission and LBW were 12.03% and 13.50%, respectively. Lower birthweight, earlier gestational age, and NICU admission were associated with worse working memory performance and receipt of early intervention services. Lower birthweight and NICU admission were also associated with slower processing speed. History of NICU admission was associated with caregiver ratings of hyperactivity and emotional dysregulation. The effects of perinatal risk factors on neurocognitive, academic, or educational outcomes were not dependent on SCD genotype.
CONCLUSIONS: History of LBW or NICU admission was associated with worse cognitive outcomes and increased use of early intervention services among children with SCD. Early identification of perinatal risk factors will help identify children who will benefit from formal developmental or neuropsychological evaluations to manage the comorbidity of SCD and perinatal risks and facilitate increased intervention.
METHODS: This prospective birth cohort study included 336 participants, ages 8-18, with SCD, who received cognitive testing as part of standard of care and whose caregivers completed behavioral rating scales. Multivariable generalized linear regression models were used to examine associations between perinatal risks and outcome variables, after adjusting for demographic and medical covariates.
RESULTS: The prevalence of NICU admission and LBW were 12.03% and 13.50%, respectively. Lower birthweight, earlier gestational age, and NICU admission were associated with worse working memory performance and receipt of early intervention services. Lower birthweight and NICU admission were also associated with slower processing speed. History of NICU admission was associated with caregiver ratings of hyperactivity and emotional dysregulation. The effects of perinatal risk factors on neurocognitive, academic, or educational outcomes were not dependent on SCD genotype.
CONCLUSIONS: History of LBW or NICU admission was associated with worse cognitive outcomes and increased use of early intervention services among children with SCD. Early identification of perinatal risk factors will help identify children who will benefit from formal developmental or neuropsychological evaluations to manage the comorbidity of SCD and perinatal risks and facilitate increased intervention.
摘要：
背景：关于经历围产期危险因素的镰状细胞病（SCD）儿童的认知和学术结果的文献有限。我们的目的是评估低出生体重(LBW)，胎龄,新生儿重症监护病房（NICU）入院史与神经认知功能相关，等级保留,或对SCD儿童接受早期干预或正规教育支持。
方法：这项前瞻性出生队列研究包括336名参与者，8-18岁，患有SCD，他们接受认知测试作为护理标准的一部分，其护理人员完成了行为评定量表。多变量广义线性回归模型用于检查围产期风险和结局变量之间的关联。在调整人口统计学和医学协变量后。
结果:NICU住院率和LBW分别为12.03%和13.50%,分别。较低的出生体重，胎龄较早，和NICU入住与工作记忆表现差和接受早期干预服务相关。较低的出生体重和NICU入院也与较慢的处理速度有关。NICU入院史与护理人员多动症和情绪失调的评分相关。围产期危险因素对神经认知的影响，学术,或教育结果不依赖于SCD基因型.
结论：在SCD儿童中，LBW或NICU入院史与认知结果较差和早期干预服务使用增加相关。早期识别围产期危险因素将有助于识别将从正式发育或神经心理学评估中受益的儿童，以管理SCD和围产期风险的共病，并促进增加干预。
方法：这项前瞻性出生队列研究包括336名参与者，8-18岁，患有SCD，他们接受认知测试作为护理标准的一部分，其护理人员完成了行为评定量表。多变量广义线性回归模型用于检查围产期风险和结局变量之间的关联。在调整人口统计学和医学协变量后。
结果:NICU住院率和LBW分别为12.03%和13.50%,分别。较低的出生体重，胎龄较早，和NICU入住与工作记忆表现差和接受早期干预服务相关。较低的出生体重和NICU入院也与较慢的处理速度有关。NICU入院史与护理人员多动症和情绪失调的评分相关。围产期危险因素对神经认知的影响，学术,或教育结果不依赖于SCD基因型.
结论：在SCD儿童中，LBW或NICU入院史与认知结果较差和早期干预服务使用增加相关。早期识别围产期危险因素将有助于识别将从正式发育或神经心理学评估中受益的儿童，以管理SCD和围产期风险的共病，并促进增加干预。
