Two-year neurodevelopmental outcome of preterm born children &lt;=750 g at birth

Claas, M.J.; Bruinse, Hein W.; Koopman, Corine; Haastert, Ingrid C. van; Peelen, LM; Vries, Linda S. de

doi:10.1136/adc.2009.174433

Cited by 46 publications

(41 citation statements)

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“…By contrast, Matilainen et al reported that both gross and fine motor skills were more impaired in SGA children (14). Other studies have also reported increased incidences of spastic motor outcomes and gross motor impairment (15,16). Of note, in our study motor skills were observed to be affected in as many as ~50% of the children in both the SGA and AGA groups.…”

Section: Discussioncontrasting

confidence: 42%

Functional outcome of very preterm–born and small-for-gestational-age children at school age

et al. 2012

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Background: Our aim was to determine functional outcome of very preterm-born and small-for-gestational-age (sGa) children as compared with matched controls at school age. Methods: We included 28 very preterm sGa children (Ga <32 wk, birth weight (BW) <10th percentile), born in 2000-2001. We also included 28 very preterm but appropriate-forgestational-age (aGa) children, matched for Ga, gender, and birth year, as controls. We assessed motor skills, intelligence quotient (IQ), attention, verbal memory, visual perception, visuomotor integration, executive functioning, and behavior of both sets of children at school age. results: The sGa children had a median Ga of 29.7 wk and BW of 888 g, whereas the controls had a median Ga of 29.4 wk and BW of 1,163 g. at 8.6 y, the median total IQ of the sGa children was 94 as compared with 95 in the controls (not significant). Performance IQ was significantly lower in sGa children (89 vs. 95, P = 0.043), whereas verbal IQ was not (95 vs. 95). Total motor skills (P = 0.048) and fine motor skills (P = 0.021) were worse in sGa children. Furthermore, sGa children scored lower on selective attention (P = 0.026) and visual perception (P = 0.025). Other scores did not differ significantly between groups. conclusion: The differences we found between the groups were small. This suggests that the impaired functioning of very preterm-born sGa children is attributable to their having been born very preterm rather than to being sGa.

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Section: Discussioncontrasting

confidence: 42%

Functional outcome of very preterm–born and small-for-gestational-age children at school age

et al. 2012

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“…Study participants were assessed between the ages of 18 and 40 months using the BSID in 13 studies, the Griffiths Mental Development Scales in 6 studies, the Stanford-Binet Intelligence Scale in 1 study, and the Brunet-Lezine Scale in 1 study. In 3 studies, 16,23,29 >1 of these assessment tools were used. School-age cognitive assessments were conducted between the ages of 5 and 18 years, and 11 different tests were used.…”

Section: Resultsmentioning

confidence: 99%

Developmental Assessments in Preterm Children: A Meta-analysis

Wong

Santhakumaran²,

Cowan

et al. 2016

Pediatrics

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CONTEXT: Developmental outcomes of very preterm (gestational age ≤32 weeks) or very low birth weight (<1500 g) children are commonly reported before age 3 years although the predictive validity for later outcomes are uncertain. OBJECTIVE:To determine the validity of early developmental assessments in predicting schoolage cognitive deficits.DATA SOURCES: PubMed. STUDY SELECTION:English-language studies reporting at least 2 serial developmental/cognitive assessments on the same population, 1 between ages 1 and 3 years and 1 at ≥5 years. DATA EXTRACTION:For each study, we calculated the sensitivity, specificity, and positive and negative predictive values of early assessment for cognitive deficit (defined as test scores 1 SD below the population mean). Pooled meta-analytic sensitivity and specificity were estimated by using a hierarchical summary receiver operator characteristic curve. RESULTS:We included 24 studies (n = 3133 children). Early assessments were conducted at 18 to 40 months and generally involved the Bayley Scales of Infant Development or the Griffiths Mental Development Scales; 11 different cognitive tests were used at school-age assessments at 5 to 18 years. Positive predictive values ranged from 20.0% to 88.9%, and negative predictive vales ranged from 47.8% to 95.5%. The pooled sensitivity (95% confidence interval) of early assessment for identifying school-age cognitive deficit was 55.0% (45.7%-63.9%) and specificity was 84.1% (77.5%-89.1%). Gestational age, birth weight, age at assessment, and time between assessments did not explain between-study heterogeneity. LIMITATIONS:The accuracy of aggregated data could not be verified. Many assessment tools have been superseded by newer editions. CONCLUSIONS:Early developmental assessment has poor sensitivity but good specificity and negative predictive value for school-age cognitive deficit.

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“…18,19 The obstetrician's willingness to intervene on fetal behalf was associated with lower stillbirth rates and improved survival in infants weighing ,1000 g but was also associated with major neonatal morbidity. 16 Approximately 25% of EPT infants born in the 1990s had a major neurodevelopmental disability at preschool age 20 ; since then, decreasing, 21 unchanged, 22,23 or increasing 19,24,25 rates of neurodevelopmental impairment (NDI) have been reported. Few studies, however, have examined outcomes after explicitly proactive care, 6,15,26 and stillbirths are seldom included in outcome studies.…”

Section: What This Study Addsmentioning

confidence: 99%

Intensity of Perinatal Care for Extremely Preterm Infants: Outcomes at 2.5 Years

et al. 2015

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, for the EXPRESS Study Group abstract OBJECTIVE: To examine the association between intensity of perinatal care and outcome at 2.5 years' corrected age (CA) in extremely preterm (EPT) infants (,27 weeks) born in Sweden during 2004-2007. METHODS: A national prospective study in 844 fetuses who were alive at the mother's admission for delivery: 707 were live born, 137 were stillborn. Infants were assigned a perinatal activity score on the basis of the intensity of care (rates of key perinatal interventions) in the infant's region of birth. Scores were calculated separately for each gestational week (gestational age [GA]-specific scores) and for the aggregated cohort (aggregated activity scores). Primary outcomes were 1-year mortality and death or neurodevelopmental disability (NDI) at 2.5 years' CA in fetuses who were alive at the mother's admission. In health care regions with higher aggregated activity scores, the risk of death or NDI at 2.5 years' CA was reduced in the primary population (aOR: 0.69; 95% CI: 0.50-0.96) and in live-born infants (aOR: 0.68; 95% CI: 0.48-0.95). Risk reductions were confined to the 22-to 24-week group. There was no difference in NDI risk between survivors at 2.5 years' CA.CONCLUSIONS: Proactive perinatal care decreased mortality without increasing the risk of NDI at 2.5 years' CA in EPT infants. A proactive approach based on optimistic expectations of a favorable outcome is justified.

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Two-year neurodevelopmental outcome of preterm born children <=750 g at birth

Abstract: Increased survival of infants with a birth weight ≤750 g coincided with more children with an impaired NDO at 2 years corrected age. SGA infants are especially at risk of impaired NDO.

Cited by 46 publications

References 50 publications

Functional outcome of very preterm–born and small-for-gestational-age children at school age

Functional outcome of very preterm–born and small-for-gestational-age children at school age

Developmental Assessments in Preterm Children: A Meta-analysis

Intensity of Perinatal Care for Extremely Preterm Infants: Outcomes at 2.5 Years

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