Model that predicted death or disabilities in premature infants was valid at seven years of age

Borregas, Salvador Piris; Valdivieso, María José Torres; Arroba, Cristina Martín-Arriscado; Bértolo, J. de la Cruz; García, Purificación Sierra; Alonso, Carmen Rosa Pallás

doi:10.1111/apa.14679

Cited by 7 publications

(7 citation statements)

References 17 publications

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“…The SMD favoured the “No ROP” group for both domains (SMD: −0.73 to −0.15; p = 0.002; I 2 =70% and SMD: −0.46 to −0.11; p = 0.001; I 2 =28%, respectively). NDI as defined by authors was reported in five studies ( n = 1,930) ( 29 , 31 , 36 , 42 , 45 ). The age at which NDI was defined varied from 3 months to 7 years of life.…”

Section: Resultsmentioning

confidence: 99%

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Retinopathy of prematurity and neurodevelopmental outcomes in preterm infants: A systematic review and meta-analysis

et al. 2023

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BackgroundRetinopathy of prematurity (ROP) and abnormal brain development share similar risk factors and mechanisms. There has been contrasting evidence on the association of ROP with adverse neurodevelopmental outcomes.ObjectiveWe analysed the association between ROP at levels of severity and treatment with all neurodevelopmental outcomes until adolescence.Data sourceWe followed PRISMA guidelines and searched Medline and Embase between 1 August 1990 and 31 March 2022.Study selection and participantsRandomised or quasi-randomised clinical trials and observational studies on preterm infants (<37 weeks) with ROP [type 1 or severe ROP, type 2 or milder ROP, laser or anti-vascular endothelial growth factor (VEGF) treated] were included.Data extraction and synthesisWe included studies on ROP and any neurocognitive or neuropsychiatric outcomes.OutcomesThe primary outcomes were as follows: cognitive composite scores evaluated between the ages of 18 and 48 months by the Bayley Scales of Infant and Toddler Development (BSID) or equivalent; neurodevelopmental impairment (NDI; moderate to severe NDI or severe NDI), cerebral palsy, cognitive impairment; and neuropsychiatric or behavioural problems. The secondary outcomes were as follows: motor and language composite scores evaluated between the ages of 18 and 48 months by BSID or equivalent; motor/language impairment; and moderate/severe NDI as defined by the authors.ResultsIn preterm infants, “any ROP” was associated with an increased risk of cognitive impairment or intellectual disability [n = 83,506; odds ratio (OR): 2.56; 95% CI: 1.40–4.69; p = 0.002], cerebral palsy (n = 3,706; OR: 2.26; 95% CI: 1.72–2.96; p < 0.001), behavioural problems (n = 81,439; OR: 2.45; 95% CI: 1.03–5.83; p = 0.04), or NDI as defined by authors (n = 1,930; OR: 3.83; 95% CI: 1.61–9.12; p = 0.002). Type 1 or severe ROP increased the risk of cerebral palsy (OR: 2.19; 95% CI: 1.23–3.88; p = 0.07), cognitive impairment or intellectual disability (n = 5,167; OR: 3.56; 95% CI: 2.6–4.86; p < 0.001), and behavioural problems (n = 5,500; OR: 2.76; 95% CI: 2.11–3.60; p < 0.001) more than type 2 ROP at 18–24 months. Infants treated with anti-VEGF had higher odds of moderate cognitive impairment than the laser surgery group if adjusted data (gestational age, sex severe intraventricular haemorrhage, bronchopulmonary dysplasia, sepsis, surgical necrotising enterocolitis, and maternal education) were analysed [adjusted OR (aOR): 1.93; 95% CI: 1.23–3.03; p = 0.04], but not for cerebral palsy (aOR: 1.29; 95% CI: 0.65–2.56; p = 0.45). All outcomes were adjudged with a “very low” certainty of evidence.Conclusion and relevanceInfants with “any ROP” had higher risks of cognitive impairment or intellectual disability, cerebral palsy, and behavioural problems. Anti-VEGF treatment increased the risk of moderate cognitive impairment. These results support the association of ROP and anti-VEGF treatment with adverse neurodevelopmental outcomes.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022326009.

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Section: Resultsmentioning

confidence: 99%

“…A total of 22 studies (10,11,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45) reported on neurodevelopmental outcomes (includes all outcomes) between "no ROP" and "any ROP." The primary outcome of CCS on BSID-III/IV was reported in five studies (n = 922) at 18-24 months (26,28,34,35,44).…”

Section: (A) Any Rop Vs No Ropmentioning

confidence: 99%

Retinopathy of prematurity and neurodevelopmental outcomes in preterm infants: A systematic review and meta-analysis

et al. 2023

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“…Nine studies explored neurodevelopmental impairment at 5–14 years of age after preterm brain injury including IVH (n=9) and WMI (n=6) 16–24. Two comparable studies highlighted a considerably increased pooled crude risk of moderate-to-severe neurodevelopmental impairment after IVH grade 3–4 at 8 years of age OR 3.69 (95% CI 1.7 to 7.98; 2 studies) I 2 =0% (figure 2, table 2).…”

Section: Resultsmentioning

confidence: 99%

School-age outcomes of children after perinatal brain injury: a systematic review and meta-analysis

Rees

Callan

Chadda

et al. 2023

bmjpo

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BackgroundOver 3000 children suffer a perinatal brain injury in England every year according to national surveillance. The childhood outcomes of infants with perinatal brain injury are however unknown.MethodsA systematic review and meta-analyses were undertaken of studies published between 2000 and September 2021 exploring school-aged neurodevelopmental outcomes of children after perinatal brain injury compared with those without perinatal brain injury. The primary outcome was neurodevelopmental impairment, which included cognitive, motor, speech and language, behavioural, hearing or visual impairment after 5 years of age.ResultsThis review included 42 studies. Preterm infants with intraventricular haemorrhage (IVH) grades 3–4 were found to have a threefold greater risk of moderate-to-severe neurodevelopmental impairment at school age OR 3.69 (95% CI 1.7 to 7.98) compared with preterm infants without IVH. Infants with perinatal stroke had an increased incidence of hemiplegia 61% (95% CI 39.2% to 82.9%) and an increased risk of cognitive impairment (difference in full scale IQ −24.2 (95% CI –30.73 to –17.67) . Perinatal stroke was also associated with poorer academic performance; and lower mean receptive −20.88 (95% CI –36.66 to –5.11) and expressive language scores −20.25 (95% CI –34.36 to –6.13) on the Clinical Evaluation of Language Fundamentals (CELF) assessment. Studies reported an increased risk of persisting neurodevelopmental impairment at school age after neonatal meningitis. Cognitive impairment and special educational needs were highlighted after moderate-to-severe hypoxic-ischaemic encephalopathy. However, there were limited comparative studies providing school-aged outcome data across neurodevelopmental domains and few provided adjusted data. Findings were further limited by the heterogeneity of studies.ConclusionsLongitudinal population studies exploring childhood outcomes after perinatal brain injury are urgently needed to better enable clinicians to prepare affected families, and to facilitate targeted developmental support to help affected children reach their full potential.

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“…The autonomy of parents in caring for their VLBW newborn infants during their admission and the dependent variables related to the morbidity of VLBW newborn infants were defined in the scientific literature 5 . Autonomy in Kangaroo Mother Care was achieved when parents transferred newborn infants from the incubator to their chest, placed their children properly in the Kangaroo position and they transferred them to the incubator.…”

Section: Methodsmentioning

confidence: 99%

“…September 2020 to 15 June 2021 and it represents the start of the implementation of the Cuídame programme. Period 2 was from 15 July 2021 to 31 May 2022 which represents complete implementation and greater experience of the neonatal team.This programme includes several areas of care and a paper called a roadmap where the parents are encouraged to write down the dates when they achieved autonomy under the supervision of the neonatal nurse staff5 . A responsible professional was assigned to each family to monitor the autonomy of the parents in caring for their babies.…”

mentioning

confidence: 99%

Parental autonomy in the care of premature newborns and experience of a neonatal team. (Preprint)

Piris-Borregas Sr,

Bellón-Vaquerizo,

Velasco-Echeburúa

et al. 2023

Preprint

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UNSTRUCTURED Introduction. The aim was to study how the time required by families of premature infants to achieve the autonomy in the care of their very low birthweight newborn infants was modified during the implementation of a training program. Patients and Method. This is an observational prospective study in the context of quality improvement strategy. The Cuídame, what means in English Take care of me program, was aimed at achieving the autonomy of the parents. It was implemented during two periods: period 1, from 1 September 2020 to 15 June 2021, and period 2, from 15 July 2021 to 31 May 2022. The days required by parents to achieve the autonomy in several areas of care were collected from the electronic health system. Results. A total of 54 and 43 patients were recruited in every period. Less time was required in the period 2 for participation in rounds (10,5 days interquartile range –IQR- 5-20 versus 7 days IQR 4-10,5, p<0,01), feeding (53,5 days IQR 34–68 versus 44,5 days IQR 37–62, p=0,05) and observation of neurobehavior (18 days IQR 9-33 versus 11 days IQR 7-16, p=0,05). More time was required for Kangaroo (14 days IQR 7-23 versus 21 days IQR 10-31, p=0,02), diaper change (9,5 days IQR 4-20 versus 14,5 days IQR 9-32, p=0,04) and infection prevention (1 day IQR 1-2 versus 6 days IQR 3-12, p<0,01). Conclusion. Families required less time for achieving the autonomy in breastfeeding, observation of neurobehavior and participation in rounds during the implementation. Nevertheless, they required more time for kangaroo, diaper change and infection prevention.

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Model that predicted death or disabilities in premature infants was valid at seven years of age

Cited by 7 publications

References 17 publications

Retinopathy of prematurity and neurodevelopmental outcomes in preterm infants: A systematic review and meta-analysis

Retinopathy of prematurity and neurodevelopmental outcomes in preterm infants: A systematic review and meta-analysis

School-age outcomes of children after perinatal brain injury: a systematic review and meta-analysis

Parental autonomy in the care of premature newborns and experience of a neonatal team. (Preprint)

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