BackgroundChildren born preterm are at heightened risk for neurodevelopmental impairment, including specific deficits in attention. Few studies have investigated change over time in attention problems prior to school entry. The current study aims to describe trajectories of attention problems from age 2 through 5 years in a cohort of children born <30 weeks of gestational age (GA), identify sociodemographic, medical, and neurobehavioral characteristics associated with attention trajectories, and test whether attention problem trajectories predict the risk of a reported attention‐deficit/hyperactivity disorder (ADHD) diagnosis.MethodsWe studied 608 infants from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a prospective, multisite study of infants born <30 weeks of GA. Parents reported on child attention problems at ages 2, 3, 4, and 5 years using the Child Behavior Checklist and the Behavior Assessment System for Children. Sociodemographic and medical characteristics were assessed via maternal interview and medical record review. Neurobehavioral characteristics were determined using neonatal and 2‐year assessments. Parent report of child ADHD diagnosis was obtained. We used latent growth curve (LGC) modeling to test our study aims.ResultsA linear LGC model provided the best fit to the data. The average trajectory of attention problems evidenced low initial levels of symptoms and little change over time, yet there was significant heterogeneity in both initial levels and change over time. Individual differences in trajectory parameters were associated with sociodemographic, medical, environmental, and neurobehavioral characteristics. Children with higher initial levels of attention problems as well as steeper increases in attention problems over time were more likely to have a reported ADHD diagnosis.ConclusionsThere is significant heterogeneity in trajectories of attention problems from age 2 to 5 in children born <30 weeks of GA and these differences have clinical relevance. These data could inform follow‐up guidelines for preterm infants.

中文翻译：

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极早产儿的学龄前儿童注意力问题的轨迹


背景早产儿患神经发育障碍的风险更高，包括特定的注意力缺陷。很少有研究调查入学前注意力问题随时间的变化。目前的研究旨在描述胎龄 （GA） 30 周出生的一组儿童从 2 岁到 5 岁的注意力问题轨迹 <，确定与注意力轨迹相关的社会人口学、医学和神经行为特征，并测试注意力问题轨迹是否预测报告的注意力缺陷/多动障碍 （ADHD） 诊断的风险。方法我们研究了来自极早产儿新生儿神经行为和结果 （NOVI） 研究的 608 名婴儿，这是一项对 GA 出生 <30 周婴儿的前瞻性多中心研究。父母使用儿童行为检查表和儿童行为评估系统报告了 2 、 3 、 4 和 5 岁时的儿童注意力问题。通过产妇访谈和病历审查评估社会人口学和医学特征。使用新生儿和 2 年评估确定神经行为特征。获得儿童 ADHD 诊断的家长报告。我们使用潜在生长曲线 （LGC） 模型来测试我们的研究目标。结果线性 LGC 模型提供了对数据的最佳拟合。注意力问题的平均轨迹表明症状的初始水平较低，随时间变化不大，但初始水平和随时间的变化都存在显着的异质性。轨迹参数的个体差异与社会人口学、医学、环境和神经行为特征相关。 随着时间的推移，初始注意力问题水平较高且注意力问题急剧增加的儿童更有可能被报告为 ADHD 诊断。结论 GA 出生 <30 周的儿童 2 至 5 岁注意力问题轨迹存在显著异质性，这些差异具有临床相关性。这些数据可以为早产儿的随访指南提供信息。