BACKGROUND To investigate the relative contributions of prenatal complications, perinatal characteristics, neonatal morbidities and socio-economic conditions on the occurrence of motor, sensory, cognitive, language and psychological disorders in a large longitudinal preterm infant population during the first 7 years after birth. METHODS The study population comprised 4122 infants born at <35 weeks of gestation who were followed for an average of 74.0 months after birth. Developmental disorders, including motor, sensory, cognitive, language and psychological, were assessed at each follow-up visit from 18 months to 7 years of age. The investigated determinants included prenatal complications (prolonged rupture of membranes >24 hours, intrauterine growth restriction, preterm labour and maternal hypertension), perinatal characteristics (gender, multiple pregnancies, gestational age, birth weight, APGAR score and intubation or ventilation in the delivery room), neonatal complications (low weight gain during hospitalization, respiratory assistance, severe neurological anomalies, nosocomial infections) and socio-economic characteristics (socio-economic level, parental separation, urbanicity). Based on hazard ratios determined using a propensity score matching approach, population-attributable fractions (PAF) were calculated for each of the four types of determinants and for each developmental disorder. RESULTS The percentages of motor, sensory, cognitive, language and psychological disorders were 17.0, 13.4, 29.1, 25.9 and 26.1%, respectively. The PAF for the perinatal characteristics were the highest and they were similar for the different developmental disorders considered (around 60%). For the neonatal and socio-economic determinants, the PAF varied according to the disorder, with contributions of up to 17% for motor and 27% for language disorders, respectively. Finally, prenatal complications had the lowest contributions (between 6 and 13%). CONCLUSIONS This study illustrates the heterogeneity of risk factors on the risk of developmental disorder in preterm infants. These results suggest the importance of considering both medical and psycho-social follow-ups of preterm infants and their families.

中文翻译：

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在7岁以下发育障碍的发生中，产前并发症，围产期特征，新生儿发病率和社会经济状况的相对贡献。

背景技术为了调查在出生后头7年中大量纵向早产婴儿的运动，感官，认知，语言和心理障碍的发生，产前并发症，围产期特征，新生儿发病率和社会经济状况的相对贡献。方法该研究人群包括4122例出生于妊娠35周以下的婴儿，平均出生后74.0个月。在18个月至7岁的每次随访中评估了发育障碍，包括运动，感觉，认知，语言和心理障碍。研究的决定因素包括产前并发症（胎膜长时间破裂> 24小时，宫内生长受限，早产和孕妇高血压），围产期特征（性别，多次怀孕，胎龄，出生体重，APGAR评分和分娩室插管或通气），新生儿并发症（住院期间体重增加低，呼吸辅助，严重的神经系统异常，医院感染）和社会经济特征（社会经济水平） ，父母分离，城市化）。基于使用倾向得分匹配方法确定的危险比，针对四种决定因素和每种发育障碍分别计算了人口归因分数（PAF）。结果运动，感官，认知，语言和心理障碍的百分比分别为17.0％，13.4％，29.1％，25.9％和26.1％。围产期特征的PAF最高，并且考虑到的不同发育障碍也相似（约60％）。对于新生儿和社会经济因素，PAF根据疾病而有所不同，分别对运动障碍和语言障碍的贡献分别高达17％和27％。最后，产前并发症的贡献最低（介于6％和13％之间）。结论本研究说明了早产儿发育障碍风险的危险因素的异质性。这些结果表明，既要考虑对早产儿及其家人进行医学随访又要进行心理社会随访。结论本研究说明了早产儿发育障碍风险的危险因素的异质性。这些结果表明，既要考虑对早产儿及其家人进行医学随访又要进行心理社会随访。结论本研究说明了早产儿发育障碍风险的危险因素的异质性。这些结果表明，既要考虑对早产儿及其家人进行医学随访又要进行心理社会随访。