Attention problems in relation to gestational age at birth and smallness for gestational age

作者：Eryigit Madzwamuse Suna; Wolke Dieter^*

来源：Early Human Development, 2015, 91(2): 131-138.

DOI：10.1016/j.earlhumdev.2015.01.004

• Child attention
• Preterm
• Gestational age at birth
• Elective caesarean birth
• Small for gestational age

Background: While it is well established that very preterm birth (gestational age at birth <32 weeks) is related to increased attention problems, there is still considerable uncertainty of the effects of moderate or late preterm birth or smallness for gestational age (SGA) on attention regulation.
Aims: To investigate the impact of gestational age at birth and SGA, birth on child attention problems.
Study design: Prospective longitudinal cohort study.
Subjects: A total of 1435 children sampled from the Bavarian Longitudinal Study (BLS).
Outcome measures: Main outcome variables were parent-reported attention problems and examiner-reported attention skills at 6 and 8 years. Predictors were linked to attention outcomes using hierarchical regression analyses.
Results: Gestational age at birth ranged from 25 weeks to 41 weeks. We found a quadratic effect of gestational age on attention problems (beta(6) (years) = 0.161,95% CI = 0.085; 0.236; beta(8) (years) = 0211,95% CI = 0.135; 0287), and attention skills at 6 and 8 years (beta(6) (years) = -0.178, 95% CI = -0.252; -0.104; beta(8) (years) = -0.169, 95% CI = -0.243; -0.094). Elective caesarean birth did not predict child attention. In adjusted models, SGA was an additional risk factor for attention problems (beta = 0.080, 95% CI = 0.026; 0.134), and attention skills = -0.091,95% CI = -0.143; -0.039) at 6 years but not at 8 years after adjusting for child sex and family SES.
Conclusion: Adverse effects on attention are disproportionately higher at early gestations. In contrast, the impact of SGA status was found to be similar at all gestational ages but disappeared by 8 years.

• 出版日期2015-2