Developmental Outcome of Preterm Infants with Intraventricular Hemorrhage at One and Two Years of Age

Abstract

Around 1980, many perinatal centers began prospective cranial screening of preterm infants using portable ultrasonography at the bedside. This study examined developmental outcome at 1 and 2 years in relation to the presence and severity of neonatal intraventricular hemorrhage (IVH). It varies from earlier reports in the size of the sample, restriction to infants without periventricular leukomalacia (PVL), and an attempt to formulate a predictive model by examining development longitudinally. Parametric and nonparametric analyses demonstrated that IVH related to Bayley mental and motor scores and neurologic ratings at 1 year but not at 2 years. Developmental delay and/or neurologic abnormality were more prevalent in infants with severe IVH but were far from universal. Regression analyses on prediction from neonatal and 1-year performance to 2-year scores revealed significant associations between the 1- and 2-year measures but not the neonatal and outcome measures. A direct insult to the CNS such as IVH thus constitutes only a limited model of risk status.

Stability of the Bayley Mental Scale of Infant Development with High Risk Infants

“…Results from medically fragile infants who completed the BSID were somewhat different, showing a decrease in scores from the first to second year. Although the pattern of results obtained for the BSID and the BSID-II differed, they were both somewhat similar to previous research on infants with multiple medical conditions showing that mental development usually is impaired to some extent, with a slight increase or decrease in test scores over the first two years of life depending on the sample examined (Rose et al, 1991;Singer et al, 1997;Sostek et al, 1987;Wilson, 1985). The differential pattern of results over time for the BSID and the BSID-II when used with medically fragile infants could be interpreted as evidence for questioning the validity of either (or both) test(s), but it is more likely a result of group differences.…”

“…The differential pattern of results over time for the BSID and the BSID-II when used with medically fragile infants could be interpreted as evidence for questioning the validity of either (or both) test(s), but it is more likely a result of group differences. Despite matching samples on primary diagnosis, age at the first assessment, age at second assessment, gender, and geographic region in which the test was administered, groups may have differed on other factors (e.g., psychosocial factors, number, type, severity, combination, and/ or management of medical illnesses, all of which may be associated with differential cognitive outcomes) (Sostek et al, 1987;Wilson, 1985;Gaiter, 1982;Meisels et al, 1986). Nevertheless, although BSID-II scores in the first year of life may underestimate cognitive abilities in the second year of life for medically fragile children, correlations between first and second year scores indicated a moderate level of stability (or systematic change), and classification agreement over time was moderate.…”

“…Yet these two groups of children may develop differently, and the stability of the BSID-II may not be ubiquitous in delayed populations. In fact, studies of mental development in children with Down syndrome have found that BSID scores drop significantly over the first two years of life (Carr, 1970), whereas studies of medically fragile children have shown that, when corrected ages are used, Bayley scores may be fairly consistent across the first two years of life, increasing or decreasing a few points, depending on the sample examined (Rose et al, 1991;Singer et al, 1997;Sostek et al, 1987;Wilson, 1985). Therefore, if the revision of the BSID is sensitive to developmental issues in high risk samples (as it was intended to be), these patterns should be evident when the BSID-II is used with these children.…”

Relation of cranial ultrasound abnormalities in low‐birthweight infants to motor or cognitive performance at ages 2, 6, and 9 years

“…Since the introduction of neonatal cranial ultrasound in the early 1980s, the relation of perinatal brain injury, particularly white-matter injury, to major disability in LBW children has been demonstrated in both hospital-based (Kitchen et al1980, Low et al 1986, Sostek et al 1987, Bozynski et al 1988, Lewis and Bendersky 1989, Stewart et al 1989, Bennett et al 1990, Whitaker et al 1990) and population-based studies (Campbell 1993, Pinto-Martin et al 1995, Whitaker et al 1996. However, the relation of perinatal brain injury, as detected by ultrasound, to more subtle problems in motor performance and general cognitive ability in LBW children without disabilities has been studied to date in small hospital-based studies only (Crowe et al 1988, Marlow et al 1989, Fawer and Calame 1991, Levene 1992, Vohr et al 1992, Marlowe et al 1993, Weisglas-Kuperus et al 1993, Fawer et al 1995.…”

The Social Competence of Children Born Prematurely: Effects of Medical Complications and Parent Behaviors

“…Study designs need to Pasamanick, Rogers, & Lilienfeld, 1956), account for this variation since different medwhile others do not (Greenberg & Cmic, ical complications are associated with differ-1988; Simonds, Silva, & Aston, 1981; Tanb, ent degrees and sites of central nervous sys- Goldstein, & Gaputo, 1977;Wemer et al, tem (CNS) insult. While abnormal mental and motor development have not been consistently associated with less severe complications such as RDS and milder degrees of IVH, many studies have documented negative outcomes of more severe medical problems such as BPD (Goldson, 1983;Landry, Chapieski, Fletcher, & Denson, 1988;Landry et al, 1984;Vohr, Bell, & Williamson, 1982) and significant degrees of IVH (Landry et al, 1984Papile, Mnnsick-Brnno, & Schaefer, 1983;Sostek et al, 1987). f^ c c x.. c >-, ciated with early birth, some related to indicators of CNS damage.…”