Int. Epidemiol：过期妊娠增加婴儿健康风险

刊载于《国际流行病学期刊》（International Journal of  Epidemiology）的一项研究表明，过期妊娠会增加新生儿的健康风险。

由荷兰鹿特丹伊拉斯漠斯儿科医学中心儿童和青少年精神病部门医生哈南·埃尔·马劳恩主持，以超过5000名胎龄大于42周的婴儿为研究对象。

英国广播公司4月3日援引马劳恩的话报道：“每一个孕妇都知道，孩子出生太早不好，那么，她们为什么不问一问孩子出生太晚带来的长期影响？”

研究人员说，胎龄超过42周的新生儿容易在幼儿时期出现行为问题，患注意力不集中症的风险是正常新生儿的两倍。

英国医疗部门认定，过期妊娠可能导致一些并发症，包括死产或因婴儿过大而难产，所以大部分母亲选择在41至42周接受引产。而在荷兰，女性42周后仍然等待自然生产的情况较为普遍。

doi: 10.1093/ije/dys043
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Post-term birth and the risk of behavioural and emotional problems in early childhood

Hanan El Marroun1,2,*, Mijke Zeegers1,3, Eric AP Steegers4, Jan van der Ende1, Jacqueline J Schenk5, Albert Hofman6, Vincent WV Jaddoe2,6,7, Frank C Verhulst1 and Henning Tiemeier

Background Post-term birth, defined as birth after pregnancy duration of 42 weeks, is associated with increased neonatal morbidity and mortality. The long-term consequences of post-term birth are unknown. We assessed the association of post-term birth with problem behaviour in early childhood. Methods The study was performed in a large population-based prospective cohort study in Rotterdam, The Netherlands. Pregnant mothers enrolled between 2001 and 2005. Of a cohort of 5145 children, 382 (7%) were born post-term, and 226 (4%) were born preterm. Parents completed a standardized and validated behavioural checklist (Child Behavior Checklist, CBCL/1.5–5) when their children were 1.5 and 3 years old. We examined the relation between gestational age (GA) at birth, based on early fetal ultrasound examination, and problem behaviour with regression analyses, adjusting for socio-economic and pregnancy-related confounders. Results A quadratic relationship between GA at birth and problem behaviour indicates that both preterm and post-term children have higher behavioural and emotional problem scores than the term born children. Compared with term born children, post-term born children had a higher risk for overall problem behaviour [odds ratio (OR)?=?2.10, 95% confidence interval (CI)?=?1.32–3.36] and were almost two and a half times as likely to have attention deficit / hyperactivity problem behaviour (OR?=?2.44, 95% CI?=?1.38–4.32). Conclusions Post-term birth was associated with more behavioural and emotional problems in early childhood, especially attention deficit / hyperactivity problem behaviour. When considering expectant management, this aspect of post-term pregnancy should be taken into account.