108139
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.4 Breast Cancer (Dove Med Press)
- 3.2 Clin Epidemiol
- 2.6 Cancer Manag Res
- 2.9 Infect Drug Resist
- 3.7 Clin Interv Aging
- 5.1 Drug Des Dev Ther
- 3.1 Int J Chronic Obstr
- 6.6 Int J Nanomed
- 2.6 Int J Women's Health
- 2.9 Neuropsych Dis Treat
- 2.8 OncoTargets Ther
- 2.0 Patient Prefer Adher
- 2.2 Ther Clin Risk Manag
- 2.5 J Pain Res
- 3.0 Diabet Metab Synd Ob
- 3.2 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 1.8 Pharmgenomics Pers Med
- 2.0 Risk Manag Healthc Policy
- 4.1 J Inflamm Res
- 2.0 Int J Gen Med
- 3.4 J Hepatocell Carcinoma
- 3.0 J Asthma Allergy
- 2.2 Clin Cosmet Investig Dermatol
- 2.4 J Multidiscip Healthc
已发表论文
睡眠呼吸障碍作为早产与学龄儿童行为问题之间的中介因素：一项针对中国上海 6 至 10 岁儿童的横断面研究
Authors Hu Y , Jiang S, Yang S, Wang C, Zou J, Guan J, Liu Y , Lu Q
Received 19 May 2025
Accepted for publication 4 September 2025
Published 8 October 2025 Volume 2025:17 Pages 2599—2610
DOI https://doi.org/10.2147/NSS.S539617
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Ahmed BaHammam
Yuli Hu,1,2,* Siqiong Jiang,1,* Shiyin Yang,3 Chunsheng Wang,4 Jianyin Zou,5 Jian Guan,5 Yupu Liu,5 Qunfeng Lu1,2
1Nursing Department of Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Xuhui, Shanghai, 200233, People’s Republic of China; 2School of Nursing, Shanghai Jiaotong University, Shanghai, 200025, People’s Republic of China; 3Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China; 4School of Medicine, Huzhou University, Zhejiang, 310000, People’s Republic of China; 5Department of Otolaryngology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yupu Liu, Email sunrisingup@163.com Qunfeng Lu, Email luluteacherliuyuan@126.com
Background: Premature birth poses a major challenge in global obstetric clinical practice. The relationship between preterm infants and behavioral problems in school-aged children remains debatable, and the mediating role of sleep-disordered breathing (SDB) in this connection has not been investigated. This study aimed to address these gaps through a large-scale cross-sectional survey.
Methods: We recruited 18,138 children aged 6– 10 from schools. Data on demographics, prematurity, SDB, and childhood behavioral problems were collected. The Paediatric Sleep Questionnaire (PSQ), a validated screening tool, assessed SDB symptoms, and the Conners’ Parent Rating Scale (CPRS) evaluated behavioral problems. Path analysis with bootstrap methods was used for statistical analysis.
Results: Among 18,138 participants, 8% (n = 1,450) were premature. After adjusting for age, gender, BMI z-score, maternal age, and maternal education level, prematurity showed a positive association with total PSQ score (B = 0.411, p < 0.01). Higher total PSQ scores were significantly associated with all six CPRS dimensions (all p < 0.05). While prematurity was not directly associated with Conduct, Psychosomatic, Impulsive-hyperactive, or Hyperactivity scores in CPRS (all p > 0.05), it demonstrated significant associations with Learning problems (β = 0.063, p = 0.005) and Anxiety scores (β = 0.076, p = 0.003). Mediation analysis showed PSQ accounted for a large proportion of associations between prematurity and Conduct, Psychosomatic, Impulsive – hyperactive, and Hyperactivity problems (95% Bootstrap CI excluded 0).
Conclusion: Premature infants may exhibit behavioral problems significantly associated with SDB, though our cross-sectional design precludes causal inference and parent-reported SDB severity may bias true associations. Future studies should utilize longitudinal cohorts to explore whether SDB is involved in the relationship between prematurity and behavioral problems (eg, anxiety). Additionally, they should conduct pilot randomized controlled trials of SDB interventions in preterm infants to assess neurodevelopmental benefits. Final conclusions require subsequent causal validation.
Keywords: premature birth, behavioral problems, sleep-disordered breathing
1Nursing Department of Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Xuhui, Shanghai, 200233, People’s Republic of China; 2School of Nursing, Shanghai Jiaotong University, Shanghai, 200025, People’s Republic of China; 3Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China; 4School of Medicine, Huzhou University, Zhejiang, 310000, People’s Republic of China; 5Department of Otolaryngology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yupu Liu, Email sunrisingup@163.com Qunfeng Lu, Email luluteacherliuyuan@126.com
Background: Premature birth poses a major challenge in global obstetric clinical practice. The relationship between preterm infants and behavioral problems in school-aged children remains debatable, and the mediating role of sleep-disordered breathing (SDB) in this connection has not been investigated. This study aimed to address these gaps through a large-scale cross-sectional survey.
Methods: We recruited 18,138 children aged 6– 10 from schools. Data on demographics, prematurity, SDB, and childhood behavioral problems were collected. The Paediatric Sleep Questionnaire (PSQ), a validated screening tool, assessed SDB symptoms, and the Conners’ Parent Rating Scale (CPRS) evaluated behavioral problems. Path analysis with bootstrap methods was used for statistical analysis.
Results: Among 18,138 participants, 8% (n = 1,450) were premature. After adjusting for age, gender, BMI z-score, maternal age, and maternal education level, prematurity showed a positive association with total PSQ score (B = 0.411, p < 0.01). Higher total PSQ scores were significantly associated with all six CPRS dimensions (all p < 0.05). While prematurity was not directly associated with Conduct, Psychosomatic, Impulsive-hyperactive, or Hyperactivity scores in CPRS (all p > 0.05), it demonstrated significant associations with Learning problems (β = 0.063, p = 0.005) and Anxiety scores (β = 0.076, p = 0.003). Mediation analysis showed PSQ accounted for a large proportion of associations between prematurity and Conduct, Psychosomatic, Impulsive – hyperactive, and Hyperactivity problems (95% Bootstrap CI excluded 0).
Conclusion: Premature infants may exhibit behavioral problems significantly associated with SDB, though our cross-sectional design precludes causal inference and parent-reported SDB severity may bias true associations. Future studies should utilize longitudinal cohorts to explore whether SDB is involved in the relationship between prematurity and behavioral problems (eg, anxiety). Additionally, they should conduct pilot randomized controlled trials of SDB interventions in preterm infants to assess neurodevelopmental benefits. Final conclusions require subsequent causal validation.
Keywords: premature birth, behavioral problems, sleep-disordered breathing