Neurodevelopmental outcome of late-preterm infants: A pragmatic review

Jois, Ravisha Srinivas

doi:10.31128/ajgp-03-18-4539

Cited by 18 publications

(11 citation statements)

References 21 publications

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“…Similarly, a study examining infants born without severe brain lesions between 2013 and 2015 reported that language developmental delay had the highest incidence (20.7%), and severe language developmental delay also had a high incidence (4.2%) 18) . Prior studies have reported that infants with a clear language developmental delay without neurological deficits continue to show language developmental delay until they reach school age 19) 11,[20][21][22][23][24] . In our study, prenatal steroid use contributed to normal development.…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental Outcomes of Very-Low-Birth-Weight Infants without Severe Brain Lesions and Impact of Postnatal Steroid Use: A Single-Center Korean Study

Jeong

Park

et al. 2022

Neonatal Med

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Purpose: We used the Bayley Scales of Infant and Toddler Development (BSID)-III to analyze the incidence and risk factors of developmental delay in very-low-birth-weight infants without severe brain lesions. We further examined the correlation between the cumulative dexamethasone dose and developmental assessment results.Methods: We retrospectively analyzed data of preterm infants (birth weight <1,500 g) admitted to our neonatal intensive care unit between January 2014 to December 2020. The BSID-III scores obtained between the corrected ages of 12 and 24 months and after 24 months were analyzed. Developmental delay was defined as a composite score of <85 for the cognition, language, and motor domains. Univariate and multivariate analyses of developmental delay risk factors and developmental changes from the first to second BSID-III were performed. Correlations between the accumulated dexamethasone dose used for bronchopulmonary dysplasia (BPD) and the first and second test scores were analyzed.Results: Seventy-one and thirty-six infants completed the first and second tests, respectively. In both tests, developmental delay was most commonly observed in the language domain (26.8%, 47.2%). In multivariate analysis, mild BPD was identified as a developmental delay risk factor (P<0.05), whereas prenatal steroid use reduced the developmental delay risk (P<0.05). All domain scores were lower in the second test than in the first test. The cognition and language domain scores in the second test decreased with increasing cumulative dexamethasone doses.Conclusion: Very-low-birth-weight infants typically experience language delay, which can persist as they age.

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Section: Discussionmentioning

confidence: 99%

Neurodevelopmental Outcomes of Very-Low-Birth-Weight Infants without Severe Brain Lesions and Impact of Postnatal Steroid Use: A Single-Center Korean Study

Jeong

Park

et al. 2022

Neonatal Med

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“…Although the prognosis among MLPT is better compared to the very preterm, the risk of developmental impairment among MLPT, compared to their term counterparts is two-three times higher 8 , 10 – 12 . During the last few months of pregnancy, the fetal brain increases rapidly in size and in complexity through intense neuronal branching, synaptogenesis and the beginning of myelination 13 , 14 .…”

Section: Introductionmentioning

confidence: 91%

“…Developmental challenges span a spectrum of domains such as cognitive, motor, behavioural, vision, hearing, sleep and language skills [5][6][7][8][9] . The severity of developmental impairment is more pronounced with decreasing gestational age, i.e.…”

Section: Introductionmentioning

confidence: 99%

Interventions to improve neurodevelopmental outcomes of children born moderate to late preterm: a systematic review protocol

et al. 2021

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Introduction: Prematurity (birth before 37+0 weeks’ gestation) is associated with wide-ranging neurodevelopmental impairment. Prognosis among moderate to late (32+0 to <37+0 weeks’ gestation) preterm infants (MLPT) is better compared to their counterparts born very preterm (<32+0 weeks’ gestation). However the risk of developmental impairment among MLPT, who make up about 84% of all preterm infants, is 2-3 times higher when compared to infants born at term. Early interventions have aimed to improve outcomes in preterm infants generally, but there are limited data on their need and effect in MLPT specifically. Prioritising research, long-term follow-up and early interventions targeted at ameliorating the impact of preterm birth among MLPT is required. Objectives: To conduct a systematic review of the type of early childhood interventions (from birth until 4 years of age) offered to MLPT children and to evaluate their impact on neurodevelopmental outcomes (cognitive, neurobehavioural and motor) as assessed in these children during childhood (until 18 years of age). Methods and analysis: A systematic literature search in Web of Science, Medline Ovid, PsycINFO, CINAHL and EMBASE will be conducted. Data on MLPT children receiving developmental interventions until the age of 4 years will be evaluated. Interventions may involve parents or primary caregivers. Primary outcomes are cognitive, neurobehavioural and motor development as measured from birth until the age of 18 years. The Cochrane Risk of Bias Assessment Tool will be used to evaluate the methodological quality of randomised controlled trials (RCTs) included in the review and will be graded as low, high or unclear risk of bias. The quality of non-RCTs will be evaluated with the Newcastle-Ottawa Scale. The quality of evidence for each outcome will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation Approach. Publication and reporting bias will be assessed using Egger’s test and funnel plots respectively.

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“…The mortality rate of preterm infants has significantly decreased recent years along with the advances of neonatal healthcare and medical treatments (Swamy et al, 2008; Glass et al, 2015; Bell et al, 2022), whereas preterm infants are still at high risk of neurodevelopmental deficiency in early life as well as late childhood mortality, and late onset mental and behavioral disorders (Vohr, 2013; Patel, 2016; Zhao et al, 2022). How to prevent the neurodevelopmental deficiencies in these infants has been put in the center of child healthcare (Srinivas Jois, 2018). Current interventional strategies in promoting neurodevelopment among preterm infants are still lacking and less than optimal due to the underlying mechanisms of neurobehavioral development understudied in these high-risk population, which hindered the timely prevention, treatment, and prediction of neurobehavioral deficiencies in the early life stages.…”

Section: Introductionmentioning

confidence: 99%

“…deficiencies in these infants has been put in the center of child healthcare (Srinivas Jois, 2018). Current interventional strategies in promoting neurodevelopment among preterm infants are still lacking and less than optimal due to the underlying mechanisms of neurobehavioral development understudied in these high-risk population, which hindered the timely prevention, treatment, and prediction of neurobehavioral deficiencies in the early life stages.…”

mentioning

confidence: 99%

The impact of early life experiences and gut microbiota on neurobehavioral development among preterm infants: A longitudinal cohort study

Chen

Zhao

et al. 2023

Preprint

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Objectives: To investigate the impact of early life experiences and gut microbiota on neurobehavioral development among preterm infants during neonatal intensive care unit (NICU) hospitalization. Methods: Preterm infants were followed from the NICU admission until their 28th postnatal day or until discharge. Daily stool samples, painful/stressful experiences, feeding patterns, and other clinical and demographic data were collected. Gut microbiota was profiled using 16S rRNA sequencing, and operational taxonomic units (OTUs) were selected to predict the neurobehaviors. The neurobehavioral development was assessed by the Neonatal Neurobehavioral Scale (NNNS) at 36 to 38 weeks of post-menstrual age (PMA). Fifty-five infants who had NNNS measurements were included in the sparse log-contrast regression analysis. Results: Preterm infants who experienced high level of pain/stress during the NICU hospitalization that were associated with higher NNNS stress/abstinence scores. Eight operational taxonomic units (OTUs) were identified to be associated with of NNNS subscales after controlling demographic and clinical features, feeding patterns, and painful/stressful experiences. These OTUs, taxa belong to seven genera including Enterobacteriaceae_unclassified, Escherichia-Shigella, Incertae_Sedis, Veillonella, Enterococcus, Clostridium_sensu_stricto_1, and Streptococcus with five belonging to Firmicutes and two belonging to Proteobacteria phylum. The enriched abundance of Enterobacteriaceae_unclassified (OTU17) and Streptococcus (OTU28) were consistently associated with less optimal neurobehavioral outcomes. The other six OTUs were also associated with infant neurobehavioral responses depending on days at NICU stay. Conclusions: This study explored the dynamic impact of specific OTUs on neurobehavioral development among preterm infants after controlling for early life experiences, i.e., acute and chronic pain/stress, and feeding in the NICU.

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Neurodevelopmental outcome of late-preterm infants: A pragmatic review

Abstract: This article is the fifth in a series on paediatric health. Articles in this series aim to provide information about diagnosis and management of presentations in infants, toddlers and pre-schoolers in general practice.

Cited by 18 publications

References 21 publications

Neurodevelopmental Outcomes of Very-Low-Birth-Weight Infants without Severe Brain Lesions and Impact of Postnatal Steroid Use: A Single-Center Korean Study

Neurodevelopmental Outcomes of Very-Low-Birth-Weight Infants without Severe Brain Lesions and Impact of Postnatal Steroid Use: A Single-Center Korean Study

Interventions to improve neurodevelopmental outcomes of children born moderate to late preterm: a systematic review protocol

The impact of early life experiences and gut microbiota on neurobehavioral development among preterm infants: A longitudinal cohort study

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