Associations of Preterm Births with Child Health and Development: Japanese Population-Based Study

作者：Kato Tsuguhiko^*; Yorifuji Takashi; Inoue Sachiko; Yamakawa Michiyo; Doi Hiroyuki; Kawachi Ichiro

来源：Journal of Pediatrics, 2013, 163(6): 1578-U98.

DOI：10.1016/j.jpeds.2013.07.004

Objective To examine associations between the duration of gestation and health and development outcomes at 2.5 years and 5.5 years using a Japanese population-based longitudinal survey (n = 47 015). %26lt;br%26gt;Study design Hospitalization was used as an indicator of physical health, and responses to questions about age-appropriate behaviors were used as an indicator of behavioral development. We conducted logistic regression analyses controlling for a set of neonatal and family factors. We also estimated population-attributable fractions. %26lt;br%26gt;Results We observed a steady increase toward shorter duration of gestation in the risk of hospitalizations at age 2.5 years and 5.5 years and developmental delays at 2.5 years (P-linear (trend) %26lt;.001 for all outcomes). We found associations only between extremely preterm birth and delayed behavioral development at age 5.5 years. %26lt;br%26gt;Conclusion There is a linear relationship between shorter duration of gestation and increased risk of later health and developmental problems. In line with Rose%26apos;s %26quot;population paradox,%26quot; the population-attributable risks for these problems are greater for moderately preterm infants compared with extremely preterm infants.

• 出版日期2013-12