Visuospatial outcomes of a prospective national cohort of young adults with very low birthweight.

IF 3.1 3区 医学 Q1 PEDIATRICS
Sarah L Harris, Lianne J Woodward, L John Horwood, Tracy R Melzer, Samudragupta Bora, Maddie Pascoe, Brian A Darlow
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引用次数: 0

Abstract

Background: Visuospatial processing is reportedly impaired in children born very preterm (VP) compared with full term (FT) controls but there are few data for VP adults.

Methods: At 26-30 years, 225 very low birthweight (VLBW) adults (70% national cohort survivors) and 100 FT controls were assessed on motor-dependent visuospatial skills using the Block Design subtest of the Wechsler Adult Intelligence Scale, and nonmotor-dependent skills by the Benton Judgment of Line Orientation and Brixton Spatial Anticipation tests. A composite score was created by summing standardized scores for the three tests. MRI measures of cortical volume, thickness and surface area were obtained for 150 VLBW participants.

Results: VLBW born adults performed less well than controls across all visuospatial measures and their composite score (P < 0.001), with moderate to large effect sizes (Cohen's ds = 0.41-0.82). Between group differences were not explained by current vision impairment, cerebral palsy, sex, ethnicity or socio-demographic factors. The unadjusted visuospatial composite score was significantly correlated with reduced cortical surface area and cortical volume, but few correlations remained significant after adjustment for age, sex and intracranial volume.

Conclusion: The visuospatial functioning of adults born VLBW is significantly poorer than their FT peers with only modest associations with cortical brain structure.

Impact: Previous reports have shown very preterm children have impaired visuospatial processing compared with term-born peers but only limited data address whether these impairments persist into adulthood. Visuospatial functioning, assessed by both motor and non-motor dependent tests, of adults born very low birthweight is significantly poorer than that of term-born peers. Poorer visuospatial functioning in this very low birthweight cohort is not explained by vision impairment and had only modest associations with cranial MRI brain structure. Persisting visuospatial impairment in very preterm adults may significantly impact quality of life. Early recognition of these difficulties could facilitate support strategies to improve outcomes.

背景:据报道,与足月儿(FT)对照组相比,早产儿(VP)的视觉空间处理能力受损,但有关早产儿成人的数据却很少:方法:对 225 名出生体重极低的成人(70% 为全国队列幸存者)和 100 名足月儿对照者在 26-30 岁时的运动依赖性视觉空间技能进行了评估,评估采用韦氏成人智力量表的块设计分测验,非运动依赖性技能则采用本顿线定向判断和布里斯顿空间预期测验。三项测试的标准化分数相加得出综合分数。核磁共振成像测量了150名VLBW参与者的大脑皮层体积、厚度和表面积:结果:在所有视觉空间测量及其综合得分方面,出生时为 VLBW 的成人的表现均低于对照组(P 结论:VLBW 出生的成人在视觉空间功能方面的表现不如对照组:VLBW 出生的成年人的视觉空间功能明显差于正常体重的同龄人,与大脑皮层结构的关系不大:以往的报告显示,与足月出生的同龄人相比,极早产儿的视觉空间处理能力受损,但只有有限的数据能说明这些缺陷是否会持续到成年。通过运动和非运动依赖测试评估,出生时体重极低的成人的视觉空间功能明显低于足月出生的同龄人。出生时体重极低的人群视觉空间功能较差的原因不是视力障碍,也与头颅磁共振成像的大脑结构关系不大。早产成人持续的视觉空间功能障碍可能会严重影响生活质量。及早发现这些困难有助于采取支持策略来改善预后。
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来源期刊
Pediatric Research
Pediatric Research 医学-小儿科
CiteScore
6.80
自引率
5.60%
发文量
473
审稿时长
3-8 weeks
期刊介绍: Pediatric Research publishes original papers, invited reviews, and commentaries on the etiologies of children''s diseases and disorders of development, extending from molecular biology to epidemiology. Use of model organisms and in vitro techniques relevant to developmental biology and medicine are acceptable, as are translational human studies
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