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台灣五歲極低體重早產兒發展初探

General Development of Taiwanese Children Born with Very-Low-Birth-Weight at 5 Years of Age: A Pilot Study

摘要


國內早產兒醫療照護追蹤系統歷經15年的發展,已臻於完善,然而關於極低體重(very low birth weight,簡稱VLBW,出生體重<1500公克)早產兒較長期的追蹤研究目前尚付之闕如。因此本研究目的為比較VLBW早產兒與足月對照組在5歲時的認知及動作發展以及探討預測VLBW早產兒5歲發展之預測因子。 共有62位5歲兒童參與本研究,31位台南地區VLBW早產兒(16位男生;平均出生體重1185公克),以及31位性別、年齡、社經地位與之配對的足月正常對照組。利用魏氏幼兒智力測驗、動作測驗、視動整合測驗、視知覺測驗、動作協調發展問卷、活動量表、文蘭適應行為量表及神經學檢查等共8項測臉來探討兩組兒童在認知、動作、視知覺、以及行為適應能力上的發展差異。也利用VLBW早產兒2歲前各階段定期追蹤之發展與醫療狀況,檢驗是否能預測5歲的發展。 研究結果發現5歲VLBW早產兒的體重與頭圍明顯比對照組兒童小;在神經動作,視知覺、認知以及行為適應能力均明顯比足月正常對照組兒童差,活動量則無顯著差異。將VLBW早產兒之身高、體重、身體質量指數(BMI)、頭圍等生長指標,與各項測驗的結果進行相關性檢驗,發現除了BMI外,身高、體重與頭圍,均與智商呈顯著相關。也發現VLBW早產兒出生後住院越久,可能代表相關疾病越嚴重,因而其視知覺與動作的發展越差,其餘因子則無預測效果。 本研究結果除了呈現目前台灣5歲VLBW早產兒的認知及動作發展狀況外,亦藉由與對照組兒童的比較,瞭解VLBW早產兒在學齡前有哪些潛在的發展問題,即使是嬰兒期發展測驗正常的兒童,他們需要家長及老師給予他們較多的關懷與協助,以降低未來對他們學業學習、人際互動或生活自理能力等方面的影響。

並列摘要


In Taiwan, the medical care and follow-up system for preterm infants had been well developed over the past 15 years. However, few longitudinal studies have been conducted on very-low-birth-weight (VLBW; <1500g) Taiwanese preschoolers. Thus, the purpose of this study was to compare the cognitive and motor developments of VLBW at five years of age with their matched full-term controls. Risk factors involved in the VLBW development at five years were also examined. We compared a cohort of 31 VLBW children (16 boys; mean birth weight 1185g) with 31 matched controls who were born at term with normal birth weights. Measures included the Wechsler Intelligence Scale for Children, The Movement Assessment Battery for Children, Test of Visual Perceptual Skills-Revised, Berry-Buktenica Developmental Test of Visual Motor Integration, Developmental Coordination Disorder Questionnaire, Activity level scale, Vineland Adaptive Behavior Scale and neurological examinations. The predictability of medical and neuromotor examinations in the VLBW before 2 years corrected age were also examined. The VLBW group had a significantly lower birth weight and smaller head circumference than the full term controls at the age of 5. Compared to the control group children, the performances of the VLBW group were inferior in terms of intelligence, neuromotor skills, visual perceptual skills, and adaptive behaviors. The weight, height, and head circumference of VLBW children were significantly correlated with their cognitive function. Findings also showed that the longer the VLBW infants were hospitalized after birth, the worse they performed in visual perception and motor skills. Other neonatal risk factors have not been identified. The results of this study not only provided longitudinal information on VLBW children in Taiwan, but also indicated the importance of regular follow ups and extensive care for VLBW children in order to minimize the influence that may arise in future educational learning, interpersonal relationships or daily maintenance.

被引用紀錄


林岱嬋(2010)。親職角色的認同、自我定位與能力評估對嬰幼兒行為動作發展之影響-親子相處狀況之中介效果初探〔碩士論文,中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834%2fCSMU.2010.00157
王嘉星(2015)。早產兒父親的人格特質與幸福感之相關研究〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831%2fTMU.2015.00033
簡素惠(2012)。探討早產兒父親之父子依附關係及相關心理社會影響因素〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2012.01376
劉綉靖(2009)。早產兒出院ㄧ個月內主要照顧者的生活品質及相關因素探討〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2009.01379
羅麗君(2009)。極低出生體重早產兒的發展與神經預後之探討〔碩士論文,亞洲大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0118-1511201215465782

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