Уважаемая Маша!
Вы чрезвычайно обрадовали меня, своей поддержкой с точки зрения мамы.
Почему-то мы все готовы решать за вас. Наверное мы не можем делать каких-либо предположений о том, что будет с вами и вашими детьми когда они вырастут, и принимать те или иные решения сейчас - на основании этого.
Результаты изучения неврологического развития таких маленьких детей есть, они достоверно хуже, чем у доношенных, но на мой взгляд должны обнадеживать в плане того, чтобы заниматься такими детьми.
например:
Pediatrics. 2002 Dec;110(6):1094-102.
Longitudinal, 15-year follow-up of children born at less than 29 weeks' gestation after introduction of surfactant therapy into a region: neurologic, cognitive, and educational outcomes.
D'Angio CT, Sinkin RA, Stevens TP, Landfish NK, Merzbach JL, Ryan RM, Phelps DL, Palumbo DR, Myers GJ.
Department of Pediatrics, Strong Children's Research Center, Golisano Children's Hospital at Strong, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA.
carl_dangio@urmc.rochester.edu
OBJECTIVE: To measure the primary and secondary school-age neurologic, cognitive, and educational outcomes in a cohort of extremely premature infants born after the introduction of exogenous surfactant therapy in a circumscribed region. METHODS: Two hundred thirteen infants born at <29 weeks' gestation were cared for at a regional referral center during 1985-1987. At primary school age, neurologic and cognitive outcomes, educational achievement, school placement, health status, and socioeconomic status were determined by follow-up visit. At secondary school age, school placement and health status were evaluated by telephone interview. RESULTS: One hundred thirty-two infants survived to school age, of whom 127 (96%) were evaluated in 1992-1995 and 126 (95%) were evaluated in 2000. Mean ages were 7.0 years at first follow-up and 14.1 years at second follow-up. At primary-school age follow-up, 19 children (15%) had cerebral palsy, 24 (19%) had a general cognitive index <70, and 41 (32%) were placed in a self-contained, special classroom. Thirty-nine children (31%) had no physical or educational impairment, whereas 27 (21%) had at least 1 severe disability. At secondary school age, cerebral palsy incidence remained unchanged, whereas 36 children (29%) were placed in a special classroom. Fifty-one children (41%) had no physical or educational impairment, whereas 24 (19%) had at least 1 severe disability. Neonatal intraventricular hemorrhage and low socioeconomic status were the strongest predictors of adverse outcomes. CONCLUSIONS: Premature infants born in the surfactant era remain at high risk of neurodevelopmental compromise. Although many of these children do well, a significant minority will require intensive special educational services through secondary school age.
Acta Paediatr. 1999 May;88(5):557-62.
Ten-year follow-up of children born before 29 gestational weeks: health, cognitive development, behaviour and school achievement.
Stjernqvist K, Svenningsen NW.
Department of Psychology, Lund University, Sweden.
Karin.Stjernqvist@itp.lu.se
Since the mid-1990s several studies have reported poor school performance in extremely preterm infants. The necessity to provide a full picture of the child's situation has been indicated. In a southern Swedish population 32,120 infants were born during the 2-y period 1985-1986. In total, 121 infants (0.4%) were reported liveborn before the 29th gestational wk and 12 (0.04%) were reported stillborn. Only 65 infants (50%) survived to the age of 10 y. The aim of this study was to evaluate the situation of extremely preterm (EPT) children at school, compared with that of full-term (FT) control children, at the age of 10 y. Health, cognitive development, school achievement and behaviour were measured. Ninety-two percent of the preterm children had no major neurological disability and most were in good health. The EPT children had an IQ of 90 +/- 15 vs 106 +/- 15 (mean +/- SD) for the FT children (p <0.001), and on the test of Visual-Motor Integration, the EPT children had 93.3 +/- 12.2 vs 109.6 +/- 14.2 for FT peers (p < 0.001). On both tests the differences between the groups corresponded to approximately one standard deviation. Thirty-eight percent of the EPT children performed below grade level at school. Thirty-two percent had general behavioural problems and 20% had attention deficit hyperactivity disorder, compared with 10% and 8%, respectively, in the FT group. EPT children require interventions to support their development and reduce behavioural problems.
С уважением, VLG.