Neurodevelopmental outcomes of extremely preterm infants in southern China: A multicenter study

Li, Yan; Meng, Danhua; Wei, Qiufen; Pan, Xinnian; Liang, Wuhua; Huang, Haiyan; Zhen, Hong; Zhang, Shuying; Wei, Yi Jhan; Wu, Chaobo; Wei, Yan-Cheng; Zhou, Junxin; Lu, Guo-Xiu

doi:10.1016/j.earlhumdev.2019.04.002

Cited by 8 publications

(12 citation statements)

References 15 publications

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“…The most recent EPIPAGE-2 study showed results more similar to ours even though infants were classified according to gestational age rather than birthweight (survival rates without neurodevelopmental impairment at 2 years of CA of 48.5%, 90.0%, and 97.5% for children born at 22-26, 27-31, and 32-34 weeks' gestation respectively) [25]. Moreover, the survival rate without developmental disabilities of our cohort of ELBW was similar to the most recent studies, with a prevalence of mild over major sequelae compared to previous ones, as shown in a recent Chinese study where 64% of infants with GA between 22 and 28 weeks survived without neurodevelopmental disabilities at 18-24 months of CA [26].…”

Section: Discussionsupporting

confidence: 89%

“…Another explanation of results discrepancies among studies may rely on the recruitment period. Indeed, our cohort includes infants born between 2005 and 2015, while others were based on cohorts enrolled between 1998- and 2007 [ 6 , 7 , 28 ],, whereas EPIPAGE-2 [ 9 ] and the Chinese study group [ 26 ] were more recent (2011 and 2016 respectively).…”

Section: Discussionmentioning

confidence: 99%

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Neurodevelopmental outcome of Italian preterm ELBW infants: an eleven years single center cohort

Caporali

Longo²,

Tritto³

et al. 2022

Ital J Pediatr

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Background Preterm extremely low birth weight infants (ELBWi) are known to be at greater risk of developing neuropsychiatric diseases. Identifying early predictors of outcome is essential to refer patients for early intervention. Few studies have investigated neurodevelopmental outcomes in Italian ELBWi. This study aims to describe neurodevelopmental outcome at 24 months of corrected age in an eleven-year single-center cohort of Italian ELBWi and to identify early risk factors for adverse neurodevelopmental outcomes. Methods All infants born with birth weight < 1000 g and admitted to the Neonatal Intensive Care Unit of the “Fondazione IRCCS Policlinico San Matteo” hospital in Pavia, Italy, from Jan 1, 2005 to Dec 31, 2015 were eligible for inclusion. At 24 months, Griffiths’ Mental Developmental Scales Extended Revised (GMDS-ER) were administered. Neurodevelopmental outcome was classified as: normal, minor sequelae (minor neurological signs, General Quotient between 76 and 87), major sequelae (cerebral palsy; General Quotient ≤ 75; severe sensory impairment). Univariate and multivariate multinomial logistic regression models were performed to analyze the correlation between neonatal variables and neurodevelopmental outcome. Results 176 ELBWi were enrolled (mean gestational age 26.52 weeks sd2.23; mean birthweight 777.45 g sd142.89). 67% showed a normal outcome at 24 months, 17% minor sequelae and 16% major sequelae (4.6% cerebral palsy on overall sample). The most frequent major sequela was cognitive impairment (8.52%). In the entire sample the median score on the Hearing-Speech subscale was lower than the median scores recorded on the other subscales and showed a significantly weaker correlation to each of the other subscales of the GMDS-ER. Severely abnormal cUS findings (RRR 10.22 p 0.043) and bronchopulmonary dysplasia (RRR 4.36 p 0.008) were independent risk factors for major sequelae and bronchopulmonary dysplasia for minor sequelae (RRR 3.00 p 0.018) on multivariate multinomial logistic regression. Conclusions This study showed an improvement in ELBWI survival rate without neurodevelopmental impairment at 24 months compared to previously reported international cohorts. Cognitive impairment was the most frequent major sequela. Median scores on GMDS-ER showed a peculiar developmental profile characterized by a selective deficit in the language domain. Severely abnormal cUS findings and bronchopulmonary dysplasia were confirmed as independent risk factors for major sequelae.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental outcome of Italian preterm ELBW infants: an eleven years single center cohort

Caporali

Longo²,

Tritto³

et al. 2022

Ital J Pediatr

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“…A meta-analysis concluded that environmental factors become more prominent while perinatal factors have less of an impact over time (1). Greater GA at birth and higher birth weight is associated with a lower risk of developmental delay (1,(3)(4)(5)(6)(7)(8). Preterm infants exposed to corticosteroids or magnesium in utero have a lower risk of cognitive delay (7).…”

Section: Developmental Delaymentioning

confidence: 99%

“…Preterm infants exposed to corticosteroids or magnesium in utero have a lower risk of cognitive delay (7). Perinatal factors that increase the risk of developmental delay are low arterial pH of umbilical cord blood, low Apgar scores, intraventricular hemorrhage (IVH), chorioamnionitis, moderate-to-severe bronchopulmonary dysplasia (BPD), prolonged mechanical ventilation, and seizures (1,4,5,8). IVH and periventricular leukomalacia (PVL) have a strong associate with poorer gross motor function (7,8).…”

Section: Developmental Delaymentioning

confidence: 99%

“…Perinatal factors that increase the risk of developmental delay are low arterial pH of umbilical cord blood, low Apgar scores, intraventricular hemorrhage (IVH), chorioamnionitis, moderate-to-severe bronchopulmonary dysplasia (BPD), prolonged mechanical ventilation, and seizures (1,4,5,8). IVH and periventricular leukomalacia (PVL) have a strong associate with poorer gross motor function (7,8). Other factors such as such as male sex, spoken language other than English, black race, lower parental education, and SES were found to be associated with poorer developmental outcomes (1,4,5,8).…”

Section: Developmental Delaymentioning

confidence: 99%

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Neurodevelopmental outcomes of preterm infants: a recent literature review

2020

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Background: Over the past several decades, improvements in technology in the Neonatal Intensive Care Unit (NICU) have led to improved survival of preterm infants. Some studies have found that premature infants are at higher risk of behavioral problems, motor and sensory abnormalities, developmental delay, and poorer academic performance, while other studies have found no significant difference.Methods: A literature search was conducted through PubMed for articles published between January 2018 and September 2019. Studies that concentrated on preterm infants with relatively uncomplicated NICU courses and without extensive medical interventions were selected.Results: Historically, preterm infants have been found to be at increased risk for the inattentive subtype of attention deficit hyperactivity disorder (ADHD), depression, anxiety, autism spectrum disorder (ASD), avoidant personality, and anti-social personality, when compared to full term infants. However, some studies found that this difference between the two groups decrease as they enter adolescence and adulthood.Preterm infants are at increased risk for language, cognitive, sensory and motor deficits. Greater gestational age (GA) at birth and higher birth weight is associated with a lower risk of developmental delay. Cohort studies focusing on motor development showed that the degree of impairment decreased over time. Adverse childhood experiences (ACEs) have a negative correlation on multiple domains of development. The overall outcome of these infants may be influenced by socioeconomic status (SES), neonatal morbidities, demographics and parental education. Hearing and vision deficits are relatively infrequent among premature infants. A significant risk factor for hearing impairment involves the use of ototoxic agents such as gentamicin and infants with a patent ductus arteriosus (PDA).Conclusions: Preterm infants are at higher risk of adverse neurodevelopmental outcomes when compared to their full-term counter parts. However, in recent years it appears that rates of certain neurologic and developmental conditions are occurring in rates lower than historically noted. Premature individuals with possible developmental or mental health concerns should be identified early on so that interventions can be implemented immediately. Those meeting developmental milestone should continue to be monitored closely as deficits may develop later.

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Evaluation of Long-term Outcomes Associated With Preterm Exposure to Antenatal Corticosteroids

et al. 2022

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IMPORTANCE Animal studies have found that antenatal corticosteroids affect many organs across multiple stages of life. However, the long-term outcomes in human children are not well understood.OBJECTIVE To conduct a systematic review and meta-analysis of long-term outcomes associated with preterm exposure to antenatal corticosteroids compared with no exposure in all children as well as children with preterm and full-term birth.DATA SOURCES Academic databases were searched for articles published from January 1, 2000, to October 29, 2021, including Ovid MEDLINE, Ovid Embase, PsycInfo, CINAHL (Cumulative Index of Nursing and Allied Health Literature), Web of Science, ClinicalTrials.gov, and Google Scholar. References of articles were also searched for relevant studies.STUDY SELECTION Randomized clinical trials (RCTs), quasi-RCTs, and cohort studies that assessed long-term neurodevelopmental, psychological, or other outcomes at 1 year or older in those who had preterm exposure to antenatal corticosteroids were included. No language restrictions were set.DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data using a piloted data extraction form. Data on study population, pregnancy characteristics, exposure to antenatal corticosteroids, and outcomes were collected. Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines were followed, and random-effects models were used for the meta-analysis. MAIN OUTCOMES AND MEASURESThe primary outcome was an author-defined composite of any adverse neurodevelopmental and/or psychological disorder. The secondary outcomes included specific measures of psychological disorders; neurodevelopmental delay; and anthropometric, metabolic, and cardiorespiratory outcomes.

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Neurodevelopmental outcomes of extremely preterm infants in southern China: A multicenter study

Cited by 8 publications

References 15 publications

Neurodevelopmental outcome of Italian preterm ELBW infants: an eleven years single center cohort

Neurodevelopmental outcome of Italian preterm ELBW infants: an eleven years single center cohort

Neurodevelopmental outcomes of preterm infants: a recent literature review

Evaluation of Long-term Outcomes Associated With Preterm Exposure to Antenatal Corticosteroids

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