Predictors of the risk of cognitive deficiency in very preterm infants: the EPIPAGE prospective cohort

Beaino, Ghada; Khoshnood, Babak; Kaminski, Monique; Marret, Stéphane; Pierrat, Véronique; Vieux, Rachel; Thiriez, Gérard; Matis, Jacqueline; Picaud, Jean‐Charles; Rozé, Jean‐Christophe; Alberge, C.; Larroque, Béatrice; Breart, Gérard; Ancel, Pierre‐Yves

doi:10.1111/j.1651-2227.2010.02064.x

Cited by 100 publications

(91 citation statements)

References 20 publications

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“…Indeed, moderate/severe cognitive impairment, an index of such factors [40,41], accounted for some of the difference in the overall behavioral problems with those having cognitive difficulties having persistently greater problems, but did not explain the excess entirely. There is growing interest in the developmental mechanisms for these disorders and evidence that cognitive deficits such as executive function and processing speed, for example, might mediate the relationship between preterm birth and behavioral, social and emotional outcomes in early and mid-childhood [42,43].…”

Section: Discussionmentioning

confidence: 96%

Trajectories of behavior, attention, social and emotional problems from childhood to early adulthood following extremely preterm birth: a prospective cohort study

Linsell

Johnson

Wolke

et al. 2018

Eur Child Adolesc Psychiatry

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To investigate trajectories of behavior, attention, social and emotional problems to early adulthood in extremely preterm survivors compared to a term-born comparison group. Longitudinal analysis of a prospective, population-based cohort of 315 surviving infants born < 26 completed weeks of gestation recruited at birth in 1995, from the UK/Republic of Ireland, and a term-born comparison group recruited at age 6. The parent-report Strengths and Difficulties Questionnaire was completed at age 6, 11, 16 and 19 years. The Total Behavioral Difficulties Score was 4.81 points higher in extremely preterm individuals compared to their term-born peers over the period (95% CI 3.76-5.87, p < 0.001) and trajectories were stable in both groups. The impact of difficulties on home life, friendships, school or work and/or leisure activities was greater in the EPT group (RR 4.28, 95% CI 2.89-6.35, p < 0.001), and hyperactivity/inattention and peer problems accounted for the largest differences. A clinically significant behavioral screen at age 2.5 was associated with a higher Total Behavioral Difficulties Score from 6 years onwards in extremely preterm participants (Mean difference 6.90, 95% CI 5.01-8.70, p < 0.0.01), as was moderate/ severe cognitive impairment at last assessment (Mean difference: 4.27, 95% CI 2.76-5.77, p < 0.001). Attention, social and emotional problems in extremely preterm individuals persist into early adulthood with significant impact on daily life. A positive behavioral screen in infancy and moderate/severe cognitive impairment are associated with early adult outcomes.

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Section: Discussionmentioning

confidence: 96%

Trajectories of behavior, attention, social and emotional problems from childhood to early adulthood following extremely preterm birth: a prospective cohort study

Linsell

Johnson

Wolke

et al. 2018

Eur Child Adolesc Psychiatry

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“…Após a alta hospitalar, a influência dos fatores ambientais / sociais mantém-se e tem sido evidenciada uma associação entre o baixo nível educacional dos pais e um pior desempenho cognitivo. 14,24,[35][36][37] Possíveis explicações podem relacionar-se com a qualidade da estimulação cognitiva oferecida pelos pais, a qual depende de fatores genéticos e da formação educacional que possuem. No presente estudo, a baixa escolaridade materna associou-se a um risco de 5,9 vezes superior de perturbações moderadas ou graves do neurodesenvolvimento.…”

Section: -unclassified

“…1,4,5 Os recém-nascidos (RN) sobreviventes apresentam risco de sequelas do neurodesenvolvimento, incluindo paralisia cerebral, défice cognitivo, visual e auditivo. [1][2][3][6][7][8][9][10][11][12][13][14][15][16] Para além da idade gestacional (IG) e do peso ao nascimento (PN), os fatores que mais se associam a sequelas no neurodesenvolvimento são a lesão cerebral major, 1,2,12-26 como a hemorragia intra-periventricular de grau igual a três, a leucomalácia periventricular quística, a displasia broncopulmonar, [22][23][24][25] a retinopatia da prematuridade [22][23][24][25] e a sépsis. 16,22,24,[27][28][29][30] Em alguns estudos foi referida a influência do género, estando o masculino associado a pior prognóstico.…”

Section: Introductionunclassified

“…16,22,24,[27][28][29][30] Em alguns estudos foi referida a influência do género, estando o masculino associado a pior prognóstico. 7,8,10,15,22 O efeito protetor dos corticoides pré-natais, 26 do aleitamento materno, 7,14,31,32 da boa evolução ponderal e do perímetro craniano foi encontrado noutros estudos. [33][34] Os fatores que influenciam o desenvolvimento neurológico são complexos.…”

Section: Introductionunclassified

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Neurodesenvolvimento em Crianças Nascidas Pré-Termo de Muito Baixo Peso: Fatores de Risco Ambientais e Biológicos

Resende¹,

Martins²,

Faria³

et al. 2017

Acta Pediátrica Port

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Introdução: Pretendeu-se avaliar o neurodesenvolvimento em recém-nascidos pré-termo de muito baixo peso aos 24-30 meses de idade e correlacioná-lo com fatores de risco biológicos e ambientais. Métodos: Estudo observacional, retrospetivo de uma coorte de crianças nascidas entre janeiro de 2005 e dezembro de 2013, com idade gestacional inferior a 32 semanas e/ou peso de nascimento inferior a 1500 g numa maternidade de apoio perinatal diferenciado. Avaliou-se o neurodesenvolvimento aos 24-30 meses através da schedule of growing skills scales II. Considerou--se como existência de sequelas moderadas / graves a presença de paralisia cerebral, quociente de desenvolvimento global inferior a 70, cegueira ou surdez neurossensorial com necessidade de prótese auditiva. Analisaram-se, por regressão logística, os fatores de risco biológicos e ambientais associados significativamente à ocorrência de défice moderado / grave. Resultados: As 551 crianças estudadas apresentavam um peso de nascimento médio de 1222 ± 320 g e idade gestacional média de 29,4 ± 2,3 semanas. Ocorreram 46/551 óbitos (8%). Obteve-se informação do neurodesenvolvimento em 439/505 (87%) crianças. Apresentaram sequelas no neurodesenvolvimento 46/439 (10%): quociente de desenvolvimento global inferior a 70, 29/439 (7%), paralisia cerebral 26/439 (6%), surdez com necessidade de prótese auditiva 8/439 (2%) e um (0,2%) caso de cegueira. No modelo de regressão logística as variáveis que se associaram de modo significativo a sequelas moderadas / graves foram a leucomalácia periventricular quística, baixa escolaridade materna, perímetro craniano inferior ao percentil 3 aos 24-30 meses, malformações congénitas, crianças inseridas em família não convencional e sépsis tardia. Discussão: Fatores biológicos e ambientais são determinantes no neurodesenvolvimento, pelo que devem ser acionadas atempadamente medidas de intervenção nas crianças mais vulneráveis. Palavras-chave:Criança; Distúrbios do Neurodesenvolvimento; Fatores de Risco; Fatores Socioeconómicos; Recém-Nascido de Muito Baixo Peso; Recém-Nascido Prematuro Abstract Introduction: We aimed to assess neurodevelopment outcome in very low birth weight preterm newborns at 24-30 months of age and to correlate it with biological and environmental risk factors. Methods: In an observational case-cohort study of infants born between January 2005 and December 2013, with gestational age less than 32 weeks and/or birth weight less than 1500 g in a maternity hospital with specialised perinatal support, we assessed neurodevelopmental outcome at 24-30 months by means of the Schedule of Growing Skills II. Moderate/severe deficit was considered to be present if the child had cerebral palsy, overall Developmental Quotient less than 70, blindness or profound sensorineural deafness requiring hearing aids. Biological and environmental risk factors independently associated with the presence of moderate/severe deficit were analysed by logistic regression. Results: The 551 children studied had a mean birth weight and gestational age of ...

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“…Contextual factors such as access to social or economic resources (e.g. social support) play an important role in influencing cognitive development in typically-developing children (23) and these can also play a key role in amplifying or conversely buffering against the detrimental effects on cognitive development of factors associated with preterm birth (26,27) .…”

Section: Regression Analysesmentioning

confidence: 99%

Parent ratings of child cognition and language compared with Bayley-III in preterm 3-year-olds

Perra

McGowan

Grunau

et al. 2015

Early Human Development

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Predictors of the risk of cognitive deficiency in very preterm infants: the EPIPAGE prospective cohort

Cited by 100 publications

References 20 publications

Trajectories of behavior, attention, social and emotional problems from childhood to early adulthood following extremely preterm birth: a prospective cohort study

Trajectories of behavior, attention, social and emotional problems from childhood to early adulthood following extremely preterm birth: a prospective cohort study

Neurodesenvolvimento em Crianças Nascidas Pré-Termo de Muito Baixo Peso: Fatores de Risco Ambientais e Biológicos

Parent ratings of child cognition and language compared with Bayley-III in preterm 3-year-olds

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