Asociación entre morbilidad neonatal, edad gestacional y déficit de desarrollo psicomotor en prematuros moderados y tardíos

Influence of perinatal complications on the development of a sample of 36-month-old premature infants

OBJECTIVE

The lack of clear results in previous studies for this context makes us consider an exploratory study. The objective of this research is to examine the influence of certain perinatal factors on the development of premature infants over their first 36 months of life.

METHOD

The sample consisted of 59 preterm infants born between 25 and 34 weeks of gestational age in an NICU of a third-level hospital. At 36 months of age, the Bayley-III Infant Development Scale (Spanish adaptation) and a clinical history were collected.

RESULTS

The average scores on the Bayley-III Infant Development Scale were generally within the normal range, but significantly lower than normal for Fine Motor Function, Gross Motor Function, and Expressive Language. These differences remained when considering the degree of prematurity, gender, and perinatal complications. Infants who received mechanical ventilation, oxygen therapy or corticosteroid treatment due to bronchopulmonary dysplasia showed the greatest discrepancies from normal levels.

CONCLUSION

Our results support prior studies that show that a combination of perinatal risk factors constitutes the largest determinant for developmental issues at 36 months of age. This information establishes the need for a priority follow-up in this population beyond 24 months of corrected age.

Impact of neonatal morbidity on the risk of developmental delay in late preterm infants

BACKGROUND

Late preterm infants (LPI) have a higher risk of developmental delay (DD) than term-born infants. The association of perinatal complications with specific morbidity is not clear.

AIM

(1) To compare the risk of DD at 4years of age between LPI who have presence or absence of any morbidity associated with the prematurity at birth, called complicated (cLPI) or uncomplicated (uLPI), and term-born infants, (2) to determine maternal and perinatal factors associated with risk of DD, and (3) to analyze, in LPI, the association between perinatal morbidity and risk of DD.

METHODS

A retrospective cohort study including 163 LPI - 47 cLPI and 116 uLPI - and 158 term-born infants (Terms) was conducted. Parents completed the Ages & Stages Questionnaires®3rd Spanish version (ASQ3). Risk of DD was defined as the presence of any ASQ3 domain scoring below the mean minus 2 SD. Association between risk of DD and maternal and perinatal factors was analysed using a multivariate logistic model. Incidence of risk of DD was analysed according to specific morbidity.

RESULTS

Compared to Terms, cLPI have a higher risk of DD in the communication domain. Respiratory pathology was associated with a higher risk in the communication domain. Caesarean delivery was the only maternal perinatal risk factor for DD, especially in gross motor domain.

CONCLUSIONS

At the age of 4years cLPI, especially those with respiratory morbidity, had a higher risk of communication delay. Caesarean delivery was the only perinatal risk factor associated with risk of DD.

Risk of developmental delay: Comparison of late preterm and full term Canadian infants at age 12 months

BACKGROUND

Late preterm (34(0/7) to 36(6/7)weeks gestation) infants may experience developmental delays greater than those found in term (≥ 37(0/7)weeks gestation) infants.

AIM

The aim of this study was to compare the risk of developmental delay between late preterm and full-term Canadian born infants at age 12months, and to determine infant and maternal factors associated with risk of delay.

METHODS

A descriptive comparative study was conducted from data available from the All Our Babies community-based, prospective, pregnancy cohort in Calgary, Alberta. Participants were a sample of mothers of 52 infants born late preterm and 156 randomly selected mothers of term infants, matched for infant sex; eligible infants were singleton births. Mothers completed a developmental screening tool, the Ages and Stages Questionnaire, version 3 (ASQ-3), when their infant was age 12months. Corrected age (CA) was used for preterm infants.

RESULTS

Both late preterm and term infants who required neonatal intensive care (NICU) were more likely to demonstrate risk of developmental delay. Compared to term infants, there was a trend for late preterm infants to be at risk of communication and gross motor delay at age 12months CA that was attenuated to the null when adjustments were made for NICU admission and other covariates.

CONCLUSIONS

Infants born between 34 and 41weeks who are admitted to NICU are at increased risk of developmental delay. Early identification of risk provides an opportunity for referral for developmental assessment and early intervention programming.