AIM We compared preschool age children born very preterm with term-born controls to: (1) understand the association between very preterm birth and community participation, (2) determine if motor impairment or social risk affect participation differently between groups, and (3) understand environmental barriers and supports to participation for parents. METHOD Forty-eight children born very preterm (<30wks' gestation; 22 males, 26 females) and 96 controls (47 males, 49 females) were assessed at 4 to 5 years' corrected age for community participation using the Young Children's Participation and Environment Measure. Motor skills were assessed using the Movement Assessment Battery for Children, Second Edition and the Little Developmental Coordination Disorder Questionnaire. RESULTS Children born very preterm participated less frequently than term-born children (difference in means=-0.28, 95% confidence interval [CI] -0.54 to -0.03, p=0.029). Social risk was associated with lower frequency (interaction p<0.001) and involvement (interaction p=0.05) in community activities for children in the very preterm group only. Parents of children born very preterm perceived more barriers (odds ratio=4.32, 95% CI 1.46-12.77, p=0.008) and environmental factors to be less supportive of participation than parents of controls (difference in medians=-6.21, 95% CI -11.42 to -1.00, p=0.02). INTERPRETATION Children born very preterm may benefit from ongoing support to promote participation, especially in families of higher social risk.

中文翻译：

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早产学龄前儿童社区参与的障碍和促进因素：一项前瞻性队列研究

目的 我们将学龄前极早产儿童与足月出生对照进行比较，以：(1) 了解极早产与社区参与之间的关联，(2) 确定运动障碍或社会风险是否对不同群体的参与产生不同的影响，以及 (3)了解环境障碍并支持父母参与。方法 48 名极早产儿（<30wks 妊娠；22 名男性，26 名女性）和 96 名对照（47 名男性，49 名女性）在 4 至 5 岁校正年龄时使用幼儿参与和环境进行社区参与评估措施。使用儿童运动评估电池，第二版和小发育协调障碍问卷评估运动技能。结果 与足月出生的孩子相比，极早产儿的参与频率较低（均值差异=-0.28，95% 置信区间 [CI] -0.54 至 -0.03，p=0.029）。社会风险仅与极早产组儿童在社区活动中的频率较低（互动 p<0.001）和参与（互动 p=0.05）相关。与对照组的父母相比，极早产儿的父母认为有更多障碍（比值比=4.32，95% CI 1.46-12.77，p=0.008）和环境因素对参与的支持较少（中位数差异=-6.21，95% CI -11.42 到 -1.00，p=0.02）。解释 极早产儿可能会受益于促进参与的持续支持，尤其是在社会风险较高的家庭中。029)。社会风险仅与极早产组儿童在社区活动中的频率较低（互动 p<0.001）和参与（互动 p=0.05）相关。与对照组的父母相比，极早产儿的父母认为有更多障碍（比值比=4.32，95% CI 1.46-12.77，p=0.008）和环境因素对参与的支持较少（中位数差异=-6.21，95% CI -11.42 到 -1.00，p=0.02）。解释 极早产儿可能会受益于促进参与的持续支持，尤其是在社会风险较高的家庭中。029)。社会风险仅与极早产组儿童在社区活动中的频率较低（互动 p<0.001）和参与（互动 p=0.05）相关。与对照组的父母相比，极早产儿的父母认为有更多障碍（比值比=4.32，95% CI 1.46-12.77，p=0.008）和环境因素对参与的支持较少（中位数差异=-6.21，95% CI -11.42 到 -1.00，p=0.02）。解释 极早产儿可能会受益于促进参与的持续支持，尤其是在社会风险较高的家庭中。95% CI 1.46-12.77，p=0.008）和环境因素对参与的支持程度低于对照组的父母（中位数差异=-6.21，95% CI -11.42 至 -1.00，p=0.02）。解释 极早产儿可能会受益于促进参与的持续支持，尤其是在社会风险较高的家庭中。95% CI 1.46-12.77，p=0.008）和环境因素对参与的支持程度低于对照组的父母（中位数差异=-6.21，95% CI -11.42 至 -1.00，p=0.02）。解释 极早产儿可能会受益于促进参与的持续支持，尤其是在社会风险较高的家庭中。