410 Perinatal Infection and Neurodevelopmental outcome in Very Preterm and Very Low Birthweight Infants: a Meta-Analysis

Abstract

Background and AimsThe Bayley Scales of Infant Development (BSID) is the most widely used measure to assess neurodevelopment of very preterm (gestational age ≤32 weeks) and very low birth weight (VLBW, ≤1500grams) infants in the first three years of life. This meta-analysis determines the predictive value of the mental subscale (MDI) and motor subscale (PDI) of the BSID for later (≥36 months) motor and cognitive development in very preterm/ VLBW children. Methods PubMed, PsychINFO and CINAHL were searched for English-language peer-reviewed studies published before April 2012. Studies were included if they reported odds ratios or correlations between the MDI/PDI scores obtained in the first three years of life, and standardized intelligence or motor assessment in childhood (≥36 months of age). Meta-analytic methods were applied to aggregate available data. Results A total of 16 studies met inclusion criteria. Across 15 studies encompassing 1335 very preterm/VLBW children, MDI scores were strongly predictive for later cognitive development, r=0.61 (95%CI: 0.57-0.64), p<0.001. The relationship between MDI scores and later cognitive development was not mediated by birth weight (p=0.56), gestational age (p=.70), and time interval between assessments (p=0.55). Across four studies including 465 very preterm/ VLBW children, PDI scores were moderately predictive for later motor function, r=0.32 (95%CI: 0.22-0.40), p<0.001. Conclusions In very preterm/VBLW children, MDI scores explain 37% of the variance in later cognitive functioning, whereas PDI scores explain 10% of later motor development. Thus a large proportion of the variance remains unexplained, underlining the importance of enhancing prediction of developmental outcomes.

Tumor necrosis factor inhibition attenuates white matter gliosis after systemic inflammation in preterm fetal sheep

“…The cause of neurodevelopmental impairment after preterm birth is multifactorial. However, there is compelling evidence that exposure to perinatal infection/inflammation is strongly associated with preterm birth and impaired neurodevelopment [2][3][4]. In recent studies, long-term neurodevelopmental impairment was associated with diffuse injury in the white matter tracts, with evidence of chronic gliosis and impaired oligodendrocyte maturation, but limited cell loss [5,6].…”

Enhancing the Follow-up Assessment of Very Preterm Children with Regard to 5-Year IQ Considering Socioeconomic Status

“…Infants born very preterm (VPT) are at increased risk of developmental problems that predominantly originate in prematurity itself. Perinatal complications, such as infectious diseases, bronchopulmonary dysplasia, necrotizing enterocolitis, periventricular leukomalacia, and intracerebral haemorrhage, contribute to grey and white matter abnormalities resulting in developmental delay and dysfunction [1][2][3][4].…”