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Early motor and mental development in very preterm infants with chronic lung disease
M Katz-Salamon1, E M Gerner, B Jonsson
1Department of Women and Child Health, Karolinska Institute, Stockholm, Sweden. mks@child.ks.se
Insights
Chronic lung disease (CLD) in preterm infants can negatively impact neurodevelopment, affecting hand-eye coordination and intelligence, even without brain lesions. Careful neurodevelopmental follow-up is crucial for these infants.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Pediatric pulmonology
Background:
- Neurological deviations are common in preterm infants with chronic lung disease (CLD).
- These deviations were previously attributed to brain lesions like intraventricular haemorrhage (IVH) or periventricular leucomalacia (PVL).
- The role of CLD itself as a risk factor for neurodevelopmental issues was unclear.
Purpose of the Study:
- To investigate if CLD, in the absence of brain lesions, poses a risk for adverse developmental outcomes in preterm infants.
- To determine the specific neurodevelopmental effects of CLD independent of major brain injury.
Main Methods:
- A cohort of 43 very low birthweight infants with CLD but no IVH or PVL was compared to 43 controls without CLD or brain lesions.
- Infants were assessed at 5 and 10 months corrected age using the Movement Assessment of Infants (MAI) scale.
- The Griffiths' developmental test was administered at 10 months corrected age.
Main Results:
- Overall motor skills assessed by MAI did not differ significantly between infants with CLD and controls.
- Significant differences were found in volitional movements (MAI), hand-eye coordination, and perceptual-intellectual abilities (Griffiths' test).
Conclusions:
- Chronic lung disease (CLD) has a detrimental impact on neurodevelopment, specifically affecting hand-eye coordination and cognitive functions.
- These findings underscore the importance of vigilant neurodevelopmental monitoring for all infants with CLD, irrespective of the presence of IVH or PVL.
Background:
The increased incidence of neurological deviations in preterm infants with chronic lung disease (CLD) has been linked to severe brain haemorrhage (intraventricular haemorrhage (IVH)) and periventricular leucomalacia (PVL) rather than to CLD per se.
Aim:
To evaluate whether CLD without concomitant brain lesions constitutes a risk factor for adverse developmental outcome.
Method:
Forty three very low birthweight infants with CLD, but without IVH or PVL, and 43 very low birthweight infants without CLD, IVH, or PVL were evaluated at 5 and 10 months of corrected age using the movement assessment of infants (MAI) scale. The Griffiths' developmental test was carried out at 10 months of age.
Results:
The overall motor assessments (MAI) in infants with CLD and controls were not significantly different. However, differences were observed in the execution of volitional movements (MAI), the total sum, hand and eye coordination, and perception and intelligence (measured by the performance scale of the Griffiths' test).
Conclusions:
CLD has a deleterious effect on the control of hand and eye coordination and on perception and intelligence. These results thus re-emphasise the necessity for careful neurodevelopmental follow up of infants with CLD whether or not they suffered IVH or PVL.