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1.
Fleur M. Rosier-van Dunné Gerda van Wezel-Meijler Laila de Groot Johanna I. de Vries 《Early human development》2010,86(2):83-86
Background
In preterm born infants abnormal general movements (GMs) generally normalize before three months post term, but may persist when perinatal brain injury is present.Aims
To assess the continuity of GM quality from fetal to early neonatal period and its relation to brain echogenicity changes.Study design
Prospective study examining GMs and three vulnerable brain areas before and 7 days after birth. The quality of GMs was classified as normal or abnormal by Gestalt-perception. The brain was examined for moderate echogenicity changes (periventricular: brighter than choroid plexus, intraventricular: filling equal or more than 50% of the ventricle, and locally increased basal ganglia/thalami).Subjects
94 fetuses from pregnancies complicated by preterm hypertensive disorders or labour at a gestational age between 26 and 34 weeks.Outcomes measures
Correlations of fetal GMs, echogenicity changes, and clinical parameters (e.g. gestational age, parity, hypertensive disorders or preterm labour, oligohydramnios and fetal growth restriction) with neonatal GMs.Results
Fetal GMs were abnormal in 64%, normalizing in 68% within 7 days after birth. Fetal GMs were significantly related to postnatal GMs (p = 0.045). Moderate fetal brain echogenicity changes and clinical parameters were not significantly related to neonatal GM.Conclusions
In this population of pregnancies compromised by hypertensive disorders or preterm labour fetal GMs correlated with neonatal GMs. Presence of moderate echogenicity changes in the fetal brain was not related to neonatal GMs. 相似文献2.
Alicia J. Spittle Lex W. Doyle Peter J. Anderson Terrie E. Inder Katherine J. Lee Jeanie L.Y. Cheong 《Early human development》2010,86(1):1-5
Background
Abnormal General Movements (GMs) early in life are predictive of later neuromotor deficits and are related to white matter abnormalities on magnetic resonance imaging (MRI). However, other structural correlates of abnormal GMs have not been defined.Aims
The objective of this study was to explore brain-metrics (linear brain measurements on MRI representative of 3-D brain volumes) at term as a predictor of abnormal GMs at 1 and 3 months' corrected age in preterm infants. It was hypothesized that abnormal GMs would be related to reduced brain-metrics in primary motor areas, namely the cerebellum and parietal lobes.Study design
Eighty three preterm infants (< 30 weeks' gestational age) were scanned at term-equivalent age. MRI was assessed for white matter abnormality and brain-metrics in six predefined brain regions (i.e. bifrontal, biparietal, lateral ventricles and transverse cerebellar diameters, and inter-hemispheric distance).Outcome measures
At 1 and 3 months' corrected age infants' GMs were assessed from video-taped footage and rated as normal or abnormal using standardized methodology.Results
At 1 month, 63% (n = 52) of infants had abnormal GMs with no association between any of the brain-metrics and abnormal GMs. At 3 months, 23% (n = 18) of infants had abnormal GMs (absent fidgety movements n = 18; abnormal fidgety movements n = 0). Reduced bifrontal, biparietal, and cerebellar transverse diameters, along with an increase in lateral ventricle sizes were associated with an increased risk of abnormal GMs at 3 months' corrected age. After controlling for white matter abnormality and grade III/IV intraventricular haemorrhage, only the cerebellar transverse diameter was predictive of abnormal GMs at 3 months.Conclusions
Reduced cerebellar diameter at term equivalent age is related to abnormal GMs at 3 months' corrected age, independent of white matter abnormality and intraventricular haemorrhage. 相似文献3.
Background
Perinatal asphyxia may result in a developmental disorder. A recently developed non-invasive tool to investigate brain function at an early age is the assessment of general movements (GMs).Aim
To evaluate relationships between perinatal risk factors and the quality of GMs in the neonatal period and at 3 months in term newborns with asphyxia in a secondary paediatric setting.Methods
64 term (> 36 weeks postmenstrual age (PMA)) infants with perinatal asphyxia were studied. GMs were assessed at ‘writhing’ GM age (38-47 weeks PMA) and at ‘fidgety’ GM age (48-56 weeks PMA). Pre- and perinatal factors were collected in a standardized way.Results
Multivariate analysis revealed that DA GMs at ‘writhing’ age mainly correlated with asphyxia related illness. DA GMs at ‘fidgety’ age correlated in particular with abnormalities on the neonatal ultrasound scan of the brain.Conclusion
In secondary paediatric settings GM-assessment especially around 3 months is a valuable tool for the assessment of the integrity of the nervous system in term infants with asphyxia. 相似文献4.
van Schie PE Rep A Ganzevoort W de Groot L Wolf H van Wassenaer AG de Vries JI;PETRA-Investigators 《Early human development》2008,84(9):605-611
Background:
Assessment of general movements (GMs) at three months is considered useful for prediction of adverse neurological outcome in high risk infants.Aims:
To study the prevalence of abnormal GMs in infants born from women with early-onset hypertensive disorders of pregnancy and the association of GMs with neurodevelopmental outcome at one year.Study design:
Prospective study, part of a randomised controlled trial of pre-birth management strategies.Subjects:
Infants born from women with early-onset hypertensive disorders of pregnancy.Outcome measures:
GMs observation and neurological examination at term and three months corrected age; at one year neurological examination and Bayley Scales of Infant Development.Results:
From 216 women included, 175 of 178 surviving infants (mean gestational age 31.6 weeks [SD 2.3], mean birth weight 1346 grams [SD 458]), were examined at three months. At term age normal, mildly abnormal and definitely abnormal GMs were observed in 54%, 36% and 10% respectively; and at three months in 47%, 40% and 13%. Mildly or definitely abnormal GMs at three months were not associated with abnormal neurological examination at one year, however, they were associated with delayed psychomotor development at one year (p = 0.01).Conclusions
In this prospective study, including small for gestational age, preterm infants about half of them did not have normal GMs at term and three months. There was no association of GMs at term nor three months with neurological outcome at one year, but there was a significant association of GMs at three months with one year psychomotor development. 相似文献5.
Patricia A.M. van Iersel Saskia C.M. Bakker Mijna Hadders-Algra 《Early human development》2010,86(7):457-461
Background
Children born preterm are known to be at risk for neurodevelopmental disorders. The role of perinatal asphyxia in this increased risk is still a matter of debate.Aim
To analyze the contribution of perinatal asphyxia in a population of preterm infants admitted to a secondary paediatric setting to neurological dysfunction in the first months after birth and to the development of cerebral palsy.Methods
17 preterm infants with perinatal asphyxia born before 35 weeks postmenstrual age (PMA) and 34 carefully matched preterm controls without asphyxia were studied. Neuromotor outcome was examined by means of three assessments of the quality of general movements (GM) at “preterm” (around 34 weeks PMA), “writhing” (around term age) and “fidgety” GM age (around 3 months post term). Follow-up until at least 18 months corrected age focused on the presence of cerebral palsy (CP).Results
GM-quality of infants with asphyxia and of those without did not differ. Multivariate analysis revealed that abnormal GMs at “preterm” age were associated with respiratory problems, those at “writhing” age with none of the assessed risk factors, and those at “fidgety” age with the severity of periventricular leukomalacia (PVL) on neonatal ultrasound scan.Perinatal asphyxia was not associated with the development of CP. CP was associated with PVL and the presence of abnormal GMs at “fidgety” age.Conclusion
Perinatal asphyxia in preterm infants is not associated with an increased risk for neurodevelopmental problems including CP. Respiratory problems during the neonatal period are associated with PVL and adverse neurological outcome. 相似文献6.
Background
General movements (GMs) form the basic motility of young infants. The quality of GMs may predict neurological outcome, but little is known about relationships between GM-quality and behavioral problems, including those resulting in overt psychiatric morbidity.Aim
To explore relationships between abnormal GMs and behavioral problems, in particular relationships between abnormal GMs and Attention Deficit Hyperactivity Disorder (ADHD) with or without psychiatric co-morbidity at school-age.Methods
Twenty-five low-risk full term infants and 16 infants at high risk for neurodevelopmental disorder but without cerebral palsy were studied prospectively. GM-quality was assessed during ‘writhing’ age (around term till 2 months post-term) and ‘fidgety’ age (2-4 months post-term). GMs were classified into normal and abnormal movements. When the children were 9-12 years, parents completed the Child Behavior Checklist (CBCL) and provided information on the presence of psychiatric diagnoses; teachers completed the Teachers Report Form (TRF). Both parents and teachers completed a questionnaire on ADHD-like behavior.Results
Abnormal GMs at ‘writhing’ and ‘fidgety’ age were related to the presence of ADHD with psychiatric co-morbidity (p < 0.05), but not to isolated ADHD. Abnormal GMs at ‘fidgety’ age were weakly related to problematic behavior at school (TRF-scores) and hyperactive behavior at home (ADHD-questionnaire).Conclusions
This explorative study suggests that abnormal GMs in early infancy may be associated with an increased risk for behavioral problems, in particular for ADHD with psychiatric co-morbidity at school-age. 相似文献7.
Hylco Bouwstra Hedwig M.J. Grooten Alice J. Koopmans Ans van Belle 《Early human development》2009,85(6):399-403
Background
The quality of general movements (GMs) is a sensitive tool to measure neurodevelopmental condition in early infancy. No information is available on prevalence rates of abnormal GMs in the general population.Objective
To assess the prevalence of abnormal GMs in the general population of three-month-old infants and to evaluate the association of abnormal GM quality with medical and social risk factors.Method
We recruited 535 infants in six well baby clinics in The Netherlands. GMs were video-taped at the corrected age of 2 to 4 months. GM-quality was assessed by two persons unaware of the infant's history. GM-quality was classified as normal optimal (NO), normal suboptimal (SO), mildly abnormal (MA) and definitely abnormal (DA). Only the last category implies clinically relevant dysfunction. Social, perinatal and postnatal characteristics were collected and their association with DA and abnormal (DA + MA) GMs were evaluated by means of univariate and logistic regression analyses.Results
GM-quality could be assessed reliably in 455 infants (85%). Seventeen infants (3.7%) showed DA GMs and 113 (25%) MA GMs. DA GMs were associated with preterm birth and smoking during pregnancy; abnormal (DA + MA) GMs with preterm birth, a relatively low level of paternal profession and urban living conditions. These factors explained between 3% and 7% of variance.Conclusion
The study indicates that the prevalence of definitely abnormal GMs in the general population is 3.7% and that of mildly abnormal GMs 25%. The clinically relevant definitely abnormal GMs were associated with preterm birth and smoking during pregnancy. 相似文献8.
Yuge M Marschik PB Nakajima Y Yamori Y Kanda T Hirota H Yoshida N Einspieler C 《Early human development》2011,87(3):231-237
Background
The quality of spontaneous general movements (GMs), assessed in the individual infant, has emerged as one of the most reliable and valid predictors especially of severe neurological impairments.Aims
To implement a more detailed assessment of GMs and co-existing movements and postural patterns in a rehabilitation clinic, and to examine to what extend is the optimality of movements and postures of infants aged 3 to 5 months related to perinatal events and the neurological outcome.Study design
Prospective study of 41 infants (15 boys and 26 girls; 11 infants born preterm) admitted to the Department of Paediatric Neurology and Rehabilitation of the St. Joseph's Hospital in Kyoto (Japan).Outcome measures
Clinical, neurological and psychological status at age 5.Results
Motor optimality at age 3 to 5 months correlated positively with neonatal optimality (r = 0.48, p < 0.01), especially regarding factors associated with hypoxic events. A non-optimal motor performance (lowest possible scores) predicted cerebral palsy with 100% accuracy. Other adverse outcomes such as developmental delays, developmental coordination disorders, pervasive developmental disorder or attention deficit hyperactivity disorder turned out not to be associated with early motor performance. In 13% of cases absence of fidgety movements proved to be false positives, but their normal appearance along with a smooth concurrent motor performance was solely found in infants with a normal neurological development.Conclusion
Assessing the quality of motor performance at age 3 to 5 months considerably improves our ability to identify infants at risk for maldevelopment. 相似文献9.
Background
It continues to be a challenge for clinicians to identify preterm infants likely to experience subsequent neurodevelopmental deficits. The Test of Infant Motor Performance (TIMP) and the assessment of spontaneous general movements (GMs) are the only reliable diagnostic and predictive tools for the functionality of the developing nervous system, if applied before term.Aim
To determine to what extent singular preterm assessments of motor performance can predict the neurodevelopmental outcome in 14-month olds.Methods
Thirty-seven preterm infants born < 34 weeks gestational age were recruited for the study at the NICU of the São Lucas University Hospital, Porto Alegre, RS, Brazil. At 34 weeks, their GMs were assessed; and the Test of Infant Motor Performance (TIMP) was applied. A prospective design was used to examine (A) the association between the GM assessment and the TIMP; and (B) the relation between GMs or the TIMP and the developmental status at 14 months, assessed by means of Alberta Infant Motor Scales (AIMS) and the Pediatric Evaluation of Disability Inventory (PEDI).Results
Nineteen infants (41%) had abnormal GMs; only one scored within the TIMP average range. Hence, GMs and TIMP were not related. Children with cramped-synchronized GMs at 34 weeks preterm had a lower AIMS centile rank than those with poor repertoire or normal GMs. There was a marginal association between cramped-synchronized GMs and a lower PEDI mobility score.Conclusions
A single preterm GM assessment is only fairly to moderately associated with the 14-month motor development. The TIMP is not suitable as a complementary assessment tool at such a young age. 相似文献10.
Background
Spectral analysis of fetal heart rate variability is promising for assessing fetal condition. Before using spectral analysis for fetal monitoring it has to be determined whether there should be a correction for gestational age or behavioural state.Aims
Compare spectral values of heart rate variability between near term and post term fetuses during active and quiet sleep.Study design
Case-control. Cases had a gestational age of ≥ 42 weeks; controls were 36 to 37 weeks. Fetuses were matched for birth weight percentile.Subjects
STAN® registrations from healthy fetuses. For each fetus one 5-minute segment was selected during active and one during quiet sleep.Outcome measures
Absolute and normalized low (0.04-0.15 Hz) and high frequency power (0.4-1.5 Hz) of heart rate variability.Results
Twenty fetuses were included. No significant differences were found between cases and controls in absolute (481 and 429 respectively, P = 0.88) or normalized low (0.78 and 0.80 respectively, P = 0.50) or absolute (41 and 21 respectively, P = 0.23) or normalized high frequency power (0.08 and 0.07 respectively, P = 0.20) during active state. During rest, normalized low frequency power was lower (0.58 and 0.69 respectively, P = 0.03) and absolute (16 and 10 respectively, P = 0.04) and normalized high frequency power were higher (0.21 and 0.14 respectively, P = 0.01) in cases compared to controls. Absolute and normalized low frequency power were higher during active state compared to rest in both groups (all P values < 0.05).Conclusions
We found sympathetic predominance during active state in fetuses around term. Post term parasympathetic modulation during rest was increased compared to near term. 相似文献11.
Objective
To assess the quality of general movements (GMs) in the first fourteen days of life in relation to obstetric and postnatal risk factors and neurodevelopmental outcome in extremely low birth weight (ELBW) infants.Study design
The GMs of nineteen infants were assessed on days 2, 4, 6, 10 and 14 with Prechtl's method. Additionally, detailed GM assessment produced optimality scores (OSs). GMs and the OSs were related to obstetric and postnatal data and to neurodevelopmental outcome at 18 months.Results
GMs and OSs fluctuated substantially during the first fourteen days of life. Most infants had abnormal GMs, especially poor repertoire (PR) GMs. No relation was found between GMs and obstetric factors. Regarding postnatal factors, septicaemia correlated to hypokinesia (H) and artificial ventilation correlated to a lower OS.Conclusions
Due to physiological disturbances the quality of GM in ELBW infants fluctuates substantially during the first fourteen days of life. Abnormal GMs, especially PR GMs, are mostly seen for the same reason. Septicaemia and artificial ventilation are associated with deterioration of the GMs (lower OSs), and in case of septicaemia also with hypokinesia. 相似文献12.
13.
Romagnoli C Tiberi E Barone G De Curtis M Regoli D Paolillo P Picone S Anania S Finocchi M Cardiello V Zecca E 《Early human development》2012,88(1):51-55
Background
Transcutaneous bilirubin (TcB) measurement is widely used as screening for neonatal hyperbilirubinaemia.Aims
To prospectively validate TcB measurement using hour-specific nomogram in identifying newborn infants not at risk for severe hyperbilirubinaemia.Study design
prospective, observational, multicenter.Subjects
2167 term and late preterm infants born in 5 neonatal units in the Lazio region of Italy.Methods
All neonates had simultaneous TcB and total serum bilirubin (TSB) measurements, when jaundice appeared and/or before hospital discharge. TcB and TSB values were plotted on a percentile-based hour-specific transcutaneous nomogram previously developed, to identify the safe percentile able to predict subsequent significant hyperbilirubinaemia defined as serum bilirubin > 17 mg/dL or need for phototherapy.Results
Fifty-five babies (2.5%) developed significant hyperbilirubinaemia. The 50th percentile of our nomogram was able to identify all babies who were at risk of significant hyperbilirubinaemia, but with a high false positive rate. Using the 75th percentile, two false negatives reduced sensitivity in the first 48 hours but we were able to detect all babies at risk after the 48th hour of age. Conclusions: This study demonstrates that the 75th percentile of our TcB nomogram is able to exclude any subsequent severe hyperbilirubinaemia from 48 h of life ahead. 相似文献14.
Treyvaud K Doyle LW Lee KJ Roberts G Cheong JL Inder TE Anderson PJ 《Early human development》2011,87(6):427-431
Background
Examining rates of difficulties in family functioning following very preterm birth has been a relatively neglected area of research.Aims
To examine family functioning, burden and parenting stress in families with very preterm compared with term born children, and investigate influences of parental mental health problems and child neurodevelopmental disability on family outcomes in families with preterm children.Study design
Participants were 184 very preterm and 71 term children and their parents. Parents completed the Family Assessment Device, Parenting Stress Index and Impact on Family questionnaires when their children were 2 years old (corrected for prematurity). Parental mental health and social risk information were also collected. Children were assessed for neurodevelopmental disability.Results
Families with very preterm children reported poorer family functioning (p = .03) compared with families with term born children, with less evidence for differences between families with very preterm and term born children in parenting stress and family burden. Within very preterm families, parental mental health problems were associated with higher levels of parenting stress (p = .001), and parents of children with a neurodevelopmental disability were more likely to report higher family burden (p = .04).Conclusions
For families with very preterm children, parental mental health symptoms and child neurodevelopmental disability may identify families at risk of greater stress and burden who may benefit from additional support. 相似文献15.
Background
Studies have suggested that different non-glucose sugars and sugar alcohols play a role in placental and fetal metabolism. However, the role of fructose in the fetal and newborn metabolism is unclear and studies are scarce.Aim
Our objective was to investigate the presence of fructose in umbilical cord blood in full-term gestation and its relationship with maternal and 48-hour-old- newborn blood concentrations, to evaluate fructose production by the fetus and newborn infant.Methods
Blood fructose and glucose concentrations were determined by HPLC in 26 paired samples of maternal blood, umbilical cord vein, and peripheral newborn blood at 48 h after birth. ANOVA, the Friedman Analysis of Variance on Ranks and the Pearson correlation with p < 0.05 were used.Results
Fructose concentration in umbilical cord blood was higher than maternal blood (p = 0.024), suggesting endogenous fructose production by the fetal-placental unit via the sorbitol pathway. Fructose concentrations were higher in newborns at 48 h after birth than in the fetal umbilical cord blood (p = 0.004), suggesting that fructose production is a continuous process from fetus to newborn.Conclusions
Fructose production by the sorbitol pathway, present in the fetus and newborn, is an alternative pathway in glucose metabolism probably used to maintain redox balance in the fetus. We suggest that endogenous fructose, similar to dietary ingested fructose, under physiological conditions produces the backbone for triacylglycerol and lipid synthesis in the fetus and newborn. Therefore the route for metabolizing fructose is already present in the early steps of human development. 相似文献16.
Geelhoed JJ van Duijn C van Osch-Gevers L Steegers EA Hofman A Helbing WA Jaddoe VW 《Early human development》2011,87(2):97-102
Background
Glucocorticoid receptor-9β polymorphism (rs6198) is associated with the susceptibility for cardiovascular disease.Aim
To examine whether the GR-9β variant is also associated with blood pressure and heart growth in early childhood.Study design
This study was embedded in a population-based prospective cohort study from fetal life onwards. Analyses were based on 857 children.Outcome measures
Left cardiac structures (aortic root diameter, left atrial diameter and left ventricular mass), shortening fraction and heart beat were measured postnatally at the ages of 1.5, 6 and 24 months. Blood pressure was measured at 24 months of age.Results
The distribution of the GR-9β genotype showed 75.1% homozygous reference, 23.5% heterozygous and 1.4% homozygous variant subjects. No differences in cardiovascular outcomes were observed at the ages of 1.5 and 6 months. At the age of 24 months, homozygous variants showed an increased systolic blood pressure of 2.65 mm Hg (95% CI: 0.16, 5.14), an increased heart rate of 9.10 beats per minute (95% CI: 1.28, 16.7) and an increased left ventricular mass of 4.99 g (95% CI: 1.33, 8.65) compared to homozygous references. This means an increase of 2.6%, 8.6% and 16%, respectively. GR-9β polymorphism was significantly associated with left ventricular mass growth during the first 2 years.Conclusion
Our findings suggest that genetically determined differences in cortisol exposure affect cardiovascular development in early life. 相似文献17.
Background
Controversy exists regarding association of high levels of proinflammatory cytokines, neonatal morbidities and poor neurodevelopment outcome in very low birth weight infants.Objective
To determine association between severity of early inflammatory response and neurodevelopment outcome in high risk very low birth weight infants.Methods
Sixty-two very preterm infants with high risk for early-onset sepsis were followed up to 24 months corrected age. Blood sample was collected for IL-6, IL-8, IL-10, IL-1β, and TNF-α analysis. Neurodevelopment outcome by Bayley Scales of Infant Development II was assessed at 22 to 24 months. Magnetic Resonance Image was performed at least once during the first 12 months.Results
In 24 (38.7%) MDI was < 85, and 16 (25.8%) had PDI < 85. Low birth weight was significantly associated with low MDI, and birth weight and periventricular leukomalacia were significantly associated with low PDI by multiple regression analysis. After controlling for birth weight and gestational age, none of the studied variables was associated with low MDI, and only periventricular leukomalacia with low PDI. Each additional 100 g in the birth weight reduced the probability of low MDI and PDI scores in 14%.Conclusions
There was no association of high cytokines plasma levels with poor neurodevelopment outcome at 22 to 24 months' corrected age, suggesting that elevations of plasma proinflammatory cytokines early in life do not play an important role in pathophysiology of brain injury in high risk preterm infants. 相似文献18.
Background
Fetal chronic hypoxia leads to centralization of circulation in order to spare the vital organs brain, adrenals and the heart. This can be documented by Doppler ultrasound. Increased blood velocity in the fetal middle cerebral artery (MCA) is an acknowledged sign of centralization of circulation in chronic hypoxia, and is called brain sparing.Aim
Our aim was to assess the relationship between signs of brain sparing in the MCA and umbilical cord blood gases at birth.Study design
A prospective study.Subjects
Singleton 57 high-risk pregnancies (outcome was compared with 21 normal pregnancies).Methods
MCA Doppler was performed within 24 h of elective caesarean section in high-risk pregnancies. Umbilical cord blood gases were analysed at birth.Main outcome measures
Cord blood gases were related to signs of centralization of fetal circulation in the MCA.Results
No correlation between signs of brain sparing in the MCA and cord blood gases. Apgar score at 5′ < 7 was seen in three newborns, but only one of these had antenatal signs of brain sparing. Newborns with antenatal brain sparing were admitted more often (p < 0.04) and had a longer duration of stay in NICU (p < 0.03) compared to newborns without brain sparing.Conclusion
Decreased pulsatility index in MCA is an acknowledged sign of fetal centralization of circulation during chronic hypoxia. However, signs of brain sparing are not related to cord blood gases at birth, which might suggest that redistribution of fetal circulation can maintain normal blood gases for a long time during chronic hypoxia. 相似文献19.
Frances V. O'Callaghan Abdullah Al Mamun Rosa Alati Jake M. Najman 《Early human development》2010,86(2):71-64
Background
Studies of the effects of maternal smoking during pregnancy have reported inconsistent findings in relation to measures of offspring cognitive functioning. Few studies, however, have examined learning outcomes in adolescents, as opposed to IQ.Aim
To examine the association between maternal smoking during pregnancy and academic performance among adolescent offspring.Study design
Population-based birth cohort study.Subjects
7223 mothers and children were enrolled in the Mater-University of Queensland Study of Pregnancy in Brisbane (Australia) from 1981 to 1984. Analyses were restricted to the 4294 mothers and children for whom all information was reported at 14-year follow-up.Outcome measures
Reports of academic performance of 14-year-old offspring in English, Science and Mathematics with different patterns of maternal smoking (never smoked, smoked before and/or after pregnancy but not during pregnancy, or smoked during pregnancy).Results
Low academic achievement was more common only in those whose mothers had smoked during pregnancy. Effect sizes were, however, small. The adjusted mean difference in total learning score for smoking before and/or after pregnancy but not during pregnancy, and for smoking during pregnancy were − 0.18 (− 0.58, 0.22) and − 0.40 (− 0.69, − 0.12). Similarly, the adjusted odds ratios were 0.9 (0. 65, 1.24) and 1.35 (1.07, 1.70).Conclusion
Maternal smoking during pregnancy is a preventable prenatal risk factor associated with small decrements in offspring academic performance that continue into adolescence. 相似文献20.
Cristina Lundqvist-Persson Gerd Lau Birgitta Strandvik Karl-Göran Sabel 《Early human development》2010,86(7):407-412