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El Rafei R, Maier RF, Jarreau PH, Norman M, Barros H, Van Reempts P, Van Heijst A, Pedersen P, Cuttini M, Johnson S, Costa R, Zemlin M, Draper ES, Zeitlin J. Postnatal growth restriction and neurodevelopment at 5 years of age: a European extremely preterm birth cohort study. Arch Dis Child Fetal Neonatal Ed 2023; 108:492-498. [PMID: 36868809 DOI: 10.1136/archdischild-2022-324988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/28/2023] [Indexed: 03/05/2023]
Abstract
OBJECTIVE To investigate whether extrauterine growth restriction (EUGR) during the neonatal hospitalisation by sex among extremely preterm (EPT) infants is associated with cerebral palsy (CP) and cognitive and motor abilities at 5 years of age. STUDY DESIGN Population-based cohort of births <28 weeks of gestation with data from obstetric and neonatal records and parental questionnaires and clinical assessments at 5 years of age. SETTING 11 European countries. PATIENTS 957 EPT infants born in 2011-2012. MAIN OUTCOMES EUGR at discharge from the neonatal unit was defined as (1) the difference between Z-scores at birth and discharge with <-2 SD as severe, -2 to -1 SD as moderate using Fenton's growth charts (Fenton) and (2) average weight-gain velocity using Patel's formula in grams (g) per kilogram per day (Patel) with <11.2 g (first quartile) as severe, 11.2-12.5 g (median) as moderate. Five-year outcomes were: a CP diagnosis, intelligence quotient (IQ) using the Wechsler Preschool and Primary Scales of Intelligence tests and motor function using the Movement Assessment Battery for Children, second edition. RESULTS 40.1% and 33.9% children were classified as having moderate and severe EUGR, respectively, by Fenton and 23.8% and 26.3% by Patel. Among children without CP, those with severe EUGR had lower IQ than children without EUGR (-3.9 points, 95% Confidence Interval (CI)=-7.2 to -0.6 for Fenton and -5.0 points, 95% CI=-8.2 to -1.8 for Patel), with no interaction by sex. No significant associations were observed between motor function and CP. CONCLUSIONS Severe EUGR among EPT infants was associated with decreased IQ at 5 years of age.
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Affiliation(s)
- Rym El Rafei
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France
- Sorbonne Université, Collège Doctoral, F-75005 Paris, France
| | - Rolf Felix Maier
- Children's Hospital, University Hospital, Philipps University Marburg, Marburg, Germany
| | - Pierre Henri Jarreau
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France
| | - Mikael Norman
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Henrique Barros
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Patrick Van Reempts
- Laboratory of Experimental Medicine and Pediatrics, Division of Neonatology, Study Centre for Perinatal Epidemiology Flanders, University of Antwerp, Flanders, Brussels, Belgium
| | - Arno Van Heijst
- Department of Neonatology, Radboud University Medical Center, Nijmegen,the Netherlands/Erasmusmc, Rotterdam, The Netherlands
| | | | - Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, Rome, Italy
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Raquel Costa
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Michael Zemlin
- Department of General Paediatrics and Neonatology, Saarland University, Saarland University Medical School, Homburg, Germany
| | | | - Jennifer Zeitlin
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France
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Reynold de Seresin M, Roy A, Theveniaut C, Le Goff J, Chopin C, Rouger V, Roze JC, Flamant C, Muller JB. Assessing of executive functions in daily life in preterm children aged 3-4 years old from the "Behavior Rating Inventory of Executive Function-Preschool version" questionnaire. Front Pediatr 2023; 11:999100. [PMID: 37565238 PMCID: PMC10410931 DOI: 10.3389/fped.2023.999100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 06/26/2023] [Indexed: 08/12/2023] Open
Abstract
Background Executive functions (EFs) are a set of neuropsychological skills permitting solving problems in a new situation by regulating action, behavior, and emotional response. As cerebral maturation remains vulnerable in preterm children, a higher risk of developing cognitive disorders including EFs exist compared to term children. Aims The aim of this study was to estimate the incidence of preschool EF impairments through proxy reports in children born preterm before 34 weeks of gestational age using the Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P) version. Secondary aims were to report neonatal, child, or socioeconomic factors associated with EF disorders. Results Parents of 357 children born preterm aged 3-4 years old completed the BRIEF-P version. Impairment in EFs was clinically significant for 13.5% of preterm children (n = 47; 95% CI = 0.10-0.18) compared to 5.1% in term children. A low parental socioeconomic level was significantly associated with impaired parent-rated EF (19.1% vs. 5.3%, p = 0.003). Conclusions Proxy reports of EF impairment are about twice as frequent as in term children. EF difficulties are not related to neonatal or child severity factors in contrast with the parental socioeconomic level. Using a parent-rated questionnaire may be a useful and easy tool to identify early the daily life impact of EF disorders on clinical follow-up of preterm children.This study was recorded in the Clinical Trials Register under identifier NCT03700463.
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Affiliation(s)
- Magali Reynold de Seresin
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
| | - Arnaud Roy
- Department of Psychology, Psychology Laboratory, University of Angers, Angers, France
- Reference Center for Learning Disabilities, Nantes University Hospital, Nantes, France
- Univ Angers, Nantes Université, LPPL, SFR CONFLUENCES, Angers, France
| | - Camille Theveniaut
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
| | - Justine Le Goff
- Reference Center for Learning Disabilities, Nantes University Hospital, Nantes, France
| | - Coline Chopin
- Reference Center for Learning Disabilities, Nantes University Hospital, Nantes, France
| | - Valérie Rouger
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
| | - Jean-Christophe Roze
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
- Epidemiologie Clinique, Centre d'Investigation Clinique (CIC004), Nantes University Hospital, Nantes, France
| | - Cyril Flamant
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
- Epidemiologie Clinique, Centre d'Investigation Clinique (CIC004), Nantes University Hospital, Nantes, France
| | - Jean-Baptiste Muller
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
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Hoberg K, Häusler M, Orlikowsky T, Lidzba K. Enhancing the Follow-up Assessment of Very Preterm Children with Regard to 5-Year IQ Considering Socioeconomic Status. Z Geburtshilfe Neonatol 2022; 226:405-415. [PMID: 35981549 DOI: 10.1055/a-1864-9895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Specifying peri- and postnatal factors in children born very preterm (VPT) that affect later outcome helps to improve long-term treatment. AIM To enhance the predictability of 5-year cognitive outcome by perinatal, 2-year developmental and socio-economic data. SUBJECTS AND OUTCOME MEASURES 92 VPT infants, born 2007-2009, gestational age<32 weeks and/or birthweight of 1500 g, were assessed longitudinally including basic neonatal, socio-economic (SES), 2-year Mental Developmental Index (MDI, Bayley Scales II), 5-year Mental Processing Composite (MPC, Kaufman-Assessment Battery for Children), and Language Screening for Preschoolers data. 5-year infants born VPT were compared to 34 term controls. RESULTS The IQ of 5-year infants born VPT was 10 points lower than that of term controls and influenced independently by preterm birth and SES. MDI, SES, birth weight and birth complications explained 48% of the variance of the MPC. The MDI proved highly predictive (r=0.6, R2=36%) for MPC but tended to underestimate the cognitive outcome. A total of 61% of the 2-year infants born VPT were already correctly classified (specificity of .93, sensitivity of .54). CHAID decision tree technique identified SES as decisive for the outcome for infants born VPT with medium MDI results (76-91): They benefit from effects associated to a higher SES, while those with a poor MDI outcome and a birth weight≤890 g do not. CONCLUSION Developmental follow-up of preterm children enhances the quality of prognosis and later outcome when differentially considering perinatal risks and SES.
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Affiliation(s)
- Kathrin Hoberg
- Department of Paediatrics, Social Paediatric Centre, Division of Neuropaediatrics and Social Paediatrics; University Hospital RWTH Aachen, RWTH Aachen University, Aachen, Germany
| | - Martin Häusler
- Department of Paediatrics, Division of Neuropediatrics and Social Pediatrics; University Hospital RWTH Aachen, RWTH Aachen University, Aachen, Germany
| | - Thorsten Orlikowsky
- Department of Paediatrics, Division of Neonatology; University Hospital RWTH Aachen, RWTH Aachen University, Aachen, Germany
| | - Karen Lidzba
- Division of Child Neurology, Department of Pediatrics, Pediatric Neurology, Inselspital University Hospital Bern, Bern, Switzerland
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Zhu Z, Shen J, Zhu Y, Wang L, Qi Q, Wang X, Li C, Andegiorgish AK, Elhoumed M, Cheng Y, Dibley MJ, Zeng L. Head circumference trajectories during the first two years of life and cognitive development, emotional, and behavior problems in adolescence: a cohort study. Eur J Pediatr 2022; 181:3401-3411. [PMID: 35802207 DOI: 10.1007/s00431-022-04554-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022]
Abstract
UNLABELLED The associations of early-life head circumference (HC) with child neurodevelopmental and mental health among generally healthy population remain unclear. We aimed to examine the associations of early-life HC trajectories with cognitive development and emotional and behavioral problems in adolescence and to identify the HC growth-sensitive period. We conducted a prospective, community-based birth cohort study in rural western China, and 745 adolescents aged 10-14 years were followed between June and December 2016. We assessed their HC eight times during the first 2 years of life and their adolescent cognitive, emotional, and behavioral outcomes using the Wechsler Intelligence Scale for Children-IV and Youth Self-Report-2001, respectively. We applied group-based trajectory modeling to identify the HC trajectories and conditional growth to derive the HC growth-sensitive periods. We identified five distinct HC trajectories characterized as Start below average-then decrease (7.8% of the sample), Start below average-then increase (6.8%), Start average-then decrease (33%), Consistently average (38%), and Consistently above average (14%). Infants in the trajectory of consistently above average had higher cognitive scores in adolescence compared to those from suboptimal trajectories, with adjusted mean differences ranging from 2.84 to 8.99 points. The conditional gains showed that the HC growth-sensitive period was between 0 and 18 months for child cognition. We found null associations between HC measures and adolescent emotional and behavioral problem scores. CONCLUSION Early-life HC trajectories were associated with adolescent cognitive development. HC may serve as an inexpensive screening tool to monitor child development at risk during the first 18 months, particularly in resource-limited settings. WHAT IS KNOWN • Postnatal head circumference (HC) has been shown to be associated with cognitive development in infants who were born premature and/or fetal growth restriction, while inconsistent associations were reported among generally healthy populations, especially in low- and middle- income countries, challenging its utility in public health practices. WHAT IS NEW • Adolescents in the HC growth trajectory of consistently above average had higher cognitive scores compared to those with other suboptimal trajectories, while null findings were observed for adolescent emotional and behavioral health. • HC may serve as an inexpensive screening tool to monitor child development at risk during the first 18 months of life, particularly in resource-limited settings.
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Affiliation(s)
- Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Jiali Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Yingze Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Liang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Qi Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xueyao Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Chao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Amanuel Kidane Andegiorgish
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Mohamed Elhoumed
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
- National Institute of Public Health Research (INRSP), BP. 695, Nouakchott, Mauritania
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Michael J Dibley
- The Sydney School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China.
- Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi, People's Republic of China.
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Selvanathan T, Guo T, Kwan E, Chau V, Brant R, Synnes AR, Grunau RE, Miller SP. Head circumference, total cerebral volume and neurodevelopment in preterm neonates. Arch Dis Child Fetal Neonatal Ed 2022; 107:181-187. [PMID: 34261769 DOI: 10.1136/archdischild-2020-321397] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/25/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the association of head circumference (HC) <10th percentile at birth and discharge from the neonatal intensive care unit (NICU) with neurodevelopment in very preterm (24-32 weeks' gestational age) neonates, and to compare the association of HC and total cerebral volume (TCV) with neurodevelopmental outcomes. DESIGN In a prospective cohort, semiautomatically segmented TCV and manually segmented white matter injury (WMI) volumes were obtained. Multivariable regressions were used to study the association of HC and TCV with neurodevelopmental outcomes, accounting for birth gestational age, WMI and postnatal illness. SETTING Participants born in 2006-2013 at British Columbia Women's Hospital were recruited. PATIENTS 168 neonates had HC measurements at birth and discharge and MRI at term-equivalent age (TEA). 143 children were assessed at 4.5 years. MAIN OUTCOME MEASURES Motor, cognitive and language outcomes at 4.5 years were assessed using the Movement Assessment Battery for Children Second Edition (M-ABC) and Wechsler Preschool and Primary Scale of Intelligence Third Edition Full Scale IQ (FSIQ) and Verbal IQ (VIQ). RESULTS Small birth HC was associated with lower M-ABC and FSIQ scores. In children with small birth HC, small discharge HC was associated with lower M-ABC, FSIQ and VIQ scores, while normal HC at discharge was no longer associated with adverse outcomes. HC strongly correlated with TCV at TEA. TCV did not correlate with outcomes. CONCLUSIONS Small birth HC is associated with poorer neurodevelopment, independent of postnatal illness and WMI. Normalisation of HC during NICU care appears to moderate this risk.
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Affiliation(s)
- Thiviya Selvanathan
- Paediatrics (Neurology), The Hospital for Sick Children, Toronto, Ontario, Canada.,Paediatrics (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Ting Guo
- Paediatrics (Neurology), The Hospital for Sick Children, Toronto, Ontario, Canada.,Paediatrics (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Eddie Kwan
- Department of Pharmacy, University of British Columbia, Vancouver, British Columbia, Canada.,BC Women's Hospital and Health Centre and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Vann Chau
- Paediatrics (Neurology), The Hospital for Sick Children, Toronto, Ontario, Canada.,Paediatrics (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Rollin Brant
- Department of Statistics, The University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Anne R Synnes
- BC Women's Hospital and Health Centre and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Pediatrics (Neonatology), The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ruth E Grunau
- BC Women's Hospital and Health Centre and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Pediatrics (Neonatology), The University of British Columbia, Vancouver, British Columbia, Canada
| | - Steven P Miller
- Paediatrics (Neurology), The Hospital for Sick Children, Toronto, Ontario, Canada .,Paediatrics (Neurology), University of Toronto, Toronto, Ontario, Canada
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Geisler I, Rausch TK, Göpel W, Spiegler J. Extremely and very preterm-born children <1500 g show different weight development in childhood compared to their peers. Acta Paediatr 2021; 110:2093-2099. [PMID: 33533506 DOI: 10.1111/apa.15785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Abstract
AIM To develop reference growth charts for body mass index (BMI), weight, length and head circumference in children born extremely preterm (EPT) or very preterm (VPT) with a birth weight <1500 g. METHODS We analysed EPT and VPT children from the German Neonatal Network born between 2009 and 2013 without chronic diseases or medications influencing growth. These data of EPT and VPT datasets were split into a training dataset and a validation dataset. In the validation dataset, data from 385 EPT and 491 VPT children from birth to age 6 years were analysed to calculate growth charts. RESULTS The percentiles of length of EPT and VPT children were comparable to German reference percentiles. The BMI peak in infancy was attenuated, and BMI was lower in all the EPT and VPT children analysed. From 2 years until 6 years of age, head circumference was lower in EPT and VPT boys and girls. CONCLUSION Deficits in height described in EPT cohorts born during the 1980 s and 1990 s were not seen in our cohort. However, EPT and VPT born children showed growth patterns that differed from national reference curves for BMI. The growth charts provided here can be used to judge the growth of EPT and VPT born children.
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Affiliation(s)
- Inga Geisler
- Department of Paediatrics University of Luebeck Luebeck Germany
| | - Tanja Katrin Rausch
- Department of Paediatrics University of Luebeck Luebeck Germany
- Institut für medizinische Biometrie und Statistik University of Luebeck Luebeck Germany
| | - Wolfgang Göpel
- Department of Paediatrics University of Luebeck Luebeck Germany
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Charpak N, Montealegre‐Pomar A, Bohorquez A. Systematic review and meta-analysis suggest that the duration of Kangaroo mother care has a direct impact on neonatal growth. Acta Paediatr 2021; 110:45-59. [PMID: 32683720 DOI: 10.1111/apa.15489] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/28/2020] [Accepted: 07/15/2020] [Indexed: 11/30/2022]
Abstract
AIM A 2016 Cochrane review showed that Kangaroo mother care (KMC) had a moderate impact on preterm growth, with high heterogeneity among studies. This systematic review and meta-analysis considered new evidence on KMC, particularly the duration. METHOD Databases were searched for papers published in English, French, Spanish and Portuguese up to 2017. Randomised controlled trials (RCT) of preterm or low birth weight infants were included if they compared growth between KMC and conventional care. Anthropometric measures were related to duration. RESULTS We identified 1368 papers, and 13 RCTs covering 743 KMC infants and 718 controls met the selection criteria. Infants held in KMC for at least 6 h/d gained more weight than the controls, with a mean difference of 8.99 g/d (95% confidence interval 8.14-9.84, I2 = 0%). This difference persisted between 2 and 6 h/d and disappeared with 2 hours or less. When we used g/kg/d, the weight gain was higher when the duration was at least 8 h/d. Only babies who received 6 h/d gained more length and head circumference. CONCLUSIONS The effect of the KMC on growth was directly related to the duration.
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Affiliation(s)
- Nathalie Charpak
- Kangaroo Foundation Bogotá Colombia
- Department of Pediatrics Faculty of Medicine Pontificia Universidad Javeriana Bogotá Colombia
| | - Adriana Montealegre‐Pomar
- Kangaroo Foundation Bogotá Colombia
- Department of Pediatrics Faculty of Medicine Pontificia Universidad Javeriana Bogotá Colombia
| | - Adriana Bohorquez
- Department of Psychiatry and Mental Health Faculty of Medicine Pontificia Universidad Javeriana Bogotá Colombia
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Medina-Alva P, Duque KR, Zea-Vera A, Bellomo S, Cárcamo C, Guillen-Pinto D, Rivas M, Tori A, Zegarra J, Cam L, Castañeda A, Villavicencio A, Ochoa TJ. Combined predictors of neurodevelopment in very low birth weight preterm infants. Early Hum Dev 2019; 130:109-115. [PMID: 30743197 PMCID: PMC6478608 DOI: 10.1016/j.earlhumdev.2019.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/13/2019] [Accepted: 01/26/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the combined prognostic value of neurological examination, head circumference and cranial ultrasound for neurodevelopmental delay (NDD) in very low birth weight (VLBW, <1500 g) preterm infants. METHODS Prospective follow-up study. Preterm infants with VLWB were assessed for NDD using the Mullen Scales of Early Learning test at 24 months of corrected age. Abnormal neurological examination (≥2 deviant items of Hammersmith neurological examination), microcephaly and major ultrasound abnormalities, each performed at term age, were evaluated as predictors of NDD in a multivariable Poisson model. RESULTS 35/132 infants (26.5%) had NDD. In the multivariable analysis, microcephaly (RR, 3.2; 95% CI, 1.6-6.7) and major ultrasound abnormalities (RR, 2.7; 95% CI, 1.3-5.7) were associated to NDD. The combination of the two tests showed the highest positive predictive value (100%; 95% CI, 51%-100%), while the combination of normal neurological examination, no major US findings and normal head size at term showed the highest negative predictive value (89%; 95% CI, 78%-95%). The maximum under receiver operating characteristic curve area was for microcephaly or major ultrasound abnormalities (AUC 0.74 (0.65-0.83)). CONCLUSION The combination of head circumference, cranial ultrasound and neurological examination at term age is useful to predict NDD in VLBW preterm infants.
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Affiliation(s)
- Pilar Medina-Alva
- School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru; Instituto Nacional Materno Perinatal, Jr Santa Rosa 941, Cercado de Lima, Lima 15001, Peru.
| | - Kevin R Duque
- School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru.
| | - Alonso Zea-Vera
- School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru
| | - Sicilia Bellomo
- School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru; Hospital Nacional Cayetano Heredia, Av Honorio Delgado 262, San Martin de Porres, Lima 15102, Peru
| | - César Cárcamo
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru.
| | - Daniel Guillen-Pinto
- School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru; Hospital Nacional Cayetano Heredia, Av Honorio Delgado 262, San Martin de Porres, Lima 15102, Peru
| | - Maria Rivas
- Hospital Nacional Madre Niño San Bartolome, Av Alfonso Ugarte 825, Lima 15001, Peru
| | - Alfredo Tori
- Hospital Nacional Guillermo Almenara, Av. Miguel Grau 800, La Victoria 15033, Lima, Peru
| | - Jaime Zegarra
- School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru; Hospital Nacional Cayetano Heredia, Av Honorio Delgado 262, San Martin de Porres, Lima 15102, Peru.
| | - Luis Cam
- Hospital Nacional Alberto Sabogal Sologuren, Jr. Colina 1081, Bellavista 07011, Callao, Peru
| | - Anne Castañeda
- Hospital Nacional Guillermo Almenara, Av. Miguel Grau 800, La Victoria 15033, Lima, Peru
| | - Aasith Villavicencio
- School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru.
| | - Theresa J Ochoa
- School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru; Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru; Center for Infectious Diseases, University of Texas Health Science Center at Houston, Houston, TX, United States.
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Goldberg DL, Becker PJ, Brigham K, Carlson S, Fleck L, Gollins L, Sandrock M, Fullmer M, Van Poots HA. Identifying Malnutrition in Preterm and Neonatal Populations: Recommended Indicators. J Acad Nutr Diet 2018; 118:1571-1582. [PMID: 29398569 DOI: 10.1016/j.jand.2017.10.006] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Indexed: 01/04/2023]
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