Neurodevelopmental trajectory in a cohort of Very Low Birth Weight Infants at preschool age: a prospective observational study.

Abstract

Background. Preterm birth is a risk factor for a baby’s neurological development. Preterm children have unusual neurodevelopmental profiles with executive, visual-motor functions, fine and gross motor skills, language and behavior that affect learning. To analyze the neurodevelopmental trajectory of a cohort of very low birth weight infants (VLBWIs) admitted to the neonatal intensive care unit (NICU) between 2014 and 2016, followed until pre-school age. Method. This is an observational cohort study. Infants were followed at birth and after NICU discharge at two- and four-year follow-ups. The two-year assessment was conducted with Bayley III, and at four years with the WPSSI and ABC Movement two scales. Results. The cohort consisted of 207 subjects with a mean gestational age (GA) of 28.9 (SD 2.6) weeks, and a mean birth weight of 1097.2 (SD 281.7) grams. At two years, children without disabilities were 90 (59.6%), those with mild disabilities 47 (31.1%), and those with moderate disabilities 14 (9.3%); at four years, 58.4% of children without previous disabilities, presented problems with verbal tests (WPSSI-ICV) and manual dexterity (MD): aiming and grasping (ME) and balance (E) at mABC2. There was significant alteration in processing speed (IVE) (p < 0.001). Further, there was a strong correlation between IVE and DM (correlation = 0.47 p < 0.001) and between IVE and ME (correlation=0.27, p = 0.0059). Conclusions. With pre-school neurodevelopmental assessment, given our cohort of ex-VLBWIs, we found more than half the children free of disability at two years, as they had presented a deficit that often involves oculo-motor coordination and processing speed.