目的:低出生体重(LBW;低于2500克)是各种神经发育困难的一般危险因素。然而,这些儿童可能仍然更容易受到几年后发生的神经和环境损害。这个前瞻性病例系列报告了患有轻度疾病的儿童,中度,或严重的创伤性脑损伤(TBI)在儿童中期,但谁也出生与出生体重低于2500克。
方法:参与者为14名轻度、中度,或严重的创伤性脑损伤(TBI),其中5名出生体重低于2500克(LBW),9名正常出生体重(NBW)的儿童。所有参与者都来自一项关于儿童TBI的长期认知和行为影响的更大研究,并在年龄上进行匹配。估计社会经济地位(SES),和TBI的严重程度(NBW儿童实际上具有稍差的整体伤害严重程度)。
结果:在基线时,两组在WJ-R字母单词识别和计算上表现出相似的分数,伦敦塔号码解决了,和CVLT-C总正确。在CELF-III公式句子(NBW>LBW)和VABS适应性行为复合和社交子域(LBW>NBW)上观察到基线组差异。超过2年,相对于NBW组,LBW组证明在两个WJ-R子测试中都有所下降,CVLT-C总正确,CELF-III制定的句子,和VABS适应行为复合和社会化。
结论:尽管由于样本量小,在性质上是初步的,研究结果表明,LBW病史会影响儿童TBI后的恢复轨迹。学术和适应性功能以及言语记忆尤其受到影响。
OBJECTIVE: Low birth weight (LBW; below 2500 grams) is a general risk factor for a variety of neurodevelopmental difficulties. However, these children may remain more vulnerable to neurologic and environmental insults occurring years later. This prospective
case series
reports on children who sustained a mild, moderate, or severe traumatic brain injury (TBI) in middle childhood but who had also been born with birth weights below 2500 grams.
METHODS: PARTICIPANTS were 14 children with mild, moderate, or severe traumatic brain injury (TBI), 5 of whom had birth weights under 2500 grams (LBW) and 9 children with normal birth weight (NBW). All participants were drawn from a larger study on the long-term cognitive and behavioral impact of pediatric TBI and were matched on age, estimated socioeconomic status (SES), and severity of TBI (with NBW children actually having a slightly worse overall injury severity).
RESULTS: At baseline, both groups exhibited similar scores on WJ-R Letter Word Identification and Calculations, Tower of London number solved, and CVLT-C total correct. Baseline group differences were observed on the CELF-III Formulated Sentences (NBW > LBW) and on the VABS Adaptive Behavior Composite and Socialization subdomain (LBW > NBW). Over 2 years, relative to the NBW group, the LBW group evidenced declines on both WJ-R subtests, CVLT-C total correct, CELF-III Formulated Sentences, and VABS Adaptive Behavior Composite and Socialization.
CONCLUSIONS: Although preliminary in nature due to small sample size, findings suggest a history of LBW influences the recovery trajectory following childhood TBI. Academic and adaptive functioning and verbal memory appeared particularly affected.