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Neurological outcome in high risk weight appropriate for gestational age preterm children at early school age
R H Largo1, L Molinari, S Kundu
1Growth and Development Centre, Universitäts-Kinderspital Zürich, Switzerland.
Insights
Most preterm children show comparable neurological development to term-born peers. However, preterm boys face higher risks for cerebral palsy and require more motor therapy, indicating a sex-based difference in neurological outcomes.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Neuroscience
Background:
- Preterm birth is a significant risk factor for adverse neurological outcomes.
- Children born preterm, even with appropriate birth weight for gestational age, require careful neurological assessment.
- Understanding long-term neurological development in this population is crucial for early intervention.
Purpose of the Study:
- To evaluate the neurological development and outcomes of preterm children at 5-6 years of age.
- To compare neurological outcomes between preterm and term-born children.
- To identify sex-specific differences in neurological development and therapeutic needs.
Main Methods:
- A longitudinal study of 97 preterm children and 93 term controls, alongside a cross-sectional study of 249 preterm children.
- Assessment of neurological development at 5-6 years of age.
- Analysis of risk factors, including outborn status, gestational age, and perinatal complications.
Main Results:
- The majority of preterm children exhibited neurological outcomes comparable to term-born controls.
- Cerebral palsy was diagnosed in 15% of preterm boys and 9% of preterm girls, with mild diplegia being most common.
- Preterm boys (14%) were more likely to receive motor therapy than term boys (2%), and preterm girls (6-9%) also required therapy, unlike term girls.
Conclusions:
- While many preterm children achieve comparable neurological development, a notable percentage experience conditions like cerebral palsy.
- Sex differences in neurological outcomes favor girls, with boys showing higher rates of impairment and need for motor therapy.
- These findings highlight the importance of continued monitoring and targeted interventions for preterm children, particularly boys.
Abstract:
Neurological development in preterm children with birth weight appropriate for gestational age is reported in two separate groups: a longitudinal study of 97 preterm children and 93 term children as a control group and a cross-sectional study of 249 preterm children. Both preterm groups were regarded as high risk with respect to number of outborns, distribution of gestational age and perinatal risk factors. Neurological outcome at 5-6 years of age in the majority of the preterm children was comparable to that of the term children. However, 15% of boys and 9% of girls in the preterm group were diagnosed as having cerebral palsy. Mild diplegia was most frequently observed; 4% of the children were severely impaired. Fourteen percent of the preterm vs 2% of the term boys and 6-9% of the preterm vs none of the term girls received motor therapy during early school age. There was a small but consistent sex difference in neurological outcome in favour of the term and preterm girls. Effects of drop out rate and of incompleteness of ascertainment are reported in detail.