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[Prognostic factors for cognitive development of very low birth weight premature children]
Maria Dalva Barbosa Baker Méio1, Claudia S Lopes, Denise Streit Morsch
1Departamento de Neonatologia, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. mdmeio@centroin.com.br
Insights
Premature infants with very low birth weight often experience cognitive deficits. Factors like being small for gestational age, abnormal brain ultrasounds, and male sex predict poorer cognitive outcomes in these children.
Area of Science:
- Neonatal development
- Pediatric neurology
- Developmental psychology
Context:
- Very low birth weight (VLBW) premature infants are at high risk for cognitive abnormalities.
- Limited data exists on the preschool-age outcomes of VLBW infants in Brazil.
- This study addresses the gap in understanding cognitive development in this vulnerable population.
Purpose:
- To describe the cognitive development of VLBW premature children in Brazil.
- To identify prognostic factors associated with cognitive abnormalities.
- To provide insights into the long-term neurodevelopmental outcomes of VLBW infants.
Summary:
- A cohort study evaluated 79 VLBW premature children aged 4-5 years using the WPPSI-R Test.
- High rates of cognitive impairment were observed, with 77.2% scoring below 1 SD and 32.9% below 2 SD.
- Small for gestational age, abnormal cerebral ultrasound, and male sex were significant predictors of lower cognitive scores.
Impact:
- Findings indicate a more severe cognitive impairment in this Brazilian cohort compared to existing literature.
- Identified prognostic factors can aid in early identification and intervention for at-risk children.
- Contributes crucial data for improving neurodevelopmental care strategies for VLBW infants.
Objective:
Very low birth weight premature children often show cognitive development abnormalities. There is scarce information about the outcome of these children at preschool age in Brazil. The objective of the study is to describe the cognitive development of a population of premature newborns and to assess possible prognostic factors for abnormalities.
Methods:
A cohort study was conducted in a preschool children population whose subjects were very low birth weight premature babies born between January 1991 and September 1993. WPPSI-R Test was used for cognitive evaluation and it was applied by psychologists. Two cut-offs were set to describe abnormality: scores below 1 and 2 standard deviations (SD).
Results:
Seventy-nine children aged 4 and 5 years were studied. The mean full WIPPSI-R score was 75.6 (+/-11.9). The incidence of abnormal 1 and 2 SD full score was 77.2% and 32.9%, respectively. After adjusting for the method of delivery, small for gestational age (OR=6.19, 95% CI 1.60-23.86), abnormal cerebral ultrasound exam (OR=5.90, 95% CI 1.04-9.83) and male sex (OR=3.20, 95% CI 1.32-26.35) were predictors of full score <70.
Conclusions:
Compared to the literature, these children showed a more severe cognitive development impairment. Small for gestational age, abnormal cerebral ultrasound exam and male sex were prognostic factors for worse outcome.