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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental outcome of preterm very low birth weight infants born from 2005 to 2007
Simona Orcesi1, Ivana Olivieri, Stefania Longo
1Child Neurology and Psychiatry Unit, IRCCS C. Mondino National Institute of Neurology Foundation, Pavia, Italy. simona.orcesi@mondino.it
Insights
This study assessed neurodevelopmental outcomes in preterm very low birth weight infants, finding a reduction in major sequelae. Key risk factors for poor outcomes were identified, confirming previous findings.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Perinatal Medicine
Background:
- Preterm very low birth weight (VLBW) infants face significant neurodevelopmental risks.
- Understanding short-term outcomes and associated factors is crucial for early intervention.
Purpose of the Study:
- To evaluate the 24-month corrected age neurodevelopmental outcome of preterm VLBW infants.
- To identify correlations between obstetric/neonatal factors and neurodevelopmental outcomes.
Main Methods:
- Followed 156 preterm VLBW infants (birth weight ≤ 1500g, GA 27-31 weeks) up to 24 months corrected age.
- Conducted neurodevelopmental assessments (neurological, psychomotor).
- Performed statistical analysis to correlate pre- and perinatal variables with outcomes.
Main Results:
- 131 infants (84%) had normal outcomes; 25 (16%) had sequelae (17 minor, 8 major).
- Risk factors for poor outcome included: preterm premature rupture of membranes, bronchodysplasia, sepsis, postnatal steroids, and male gender.
- Abnormal brain ultrasound and neurological assessment at term equivalent age predicted poor outcome.
Conclusions:
- Short-term neurodevelopmental outcomes for preterm VLBW infants born 2005-2007 in Italy showed a reduction in major sequelae.
- Identified risk factors for poor neurodevelopmental outcome largely align with those from earlier periods.
Objective:
To evaluate short-term neurodevelopmental outcome (at 24 months of corrected age) and correlations with obstetric and neonatal factors in a sample of preterm very low birth weight infants born and admitted to an Italian tertiary centre between 2005 and 2007.
Methods:
156 infants with a birth weight ≤ 1500 g (gestational age, range: 27-31 weeks) were followed at regular intervals through neurodevelopmental (neurological and psychomotor) assessment up to 24 months of corrected age. A statistical analysis was conducted in order to look for correlations between pre- and perinatal variables and neuropsychomotor outcome at 24 months.
Results:
131 children were classified as normal and the other 25 presented sequelae classified as "minor" in 17 cases and as "major" in eight. The most significant risk factors for a poor outcome were preterm premature rupture of the membranes, bronchodysplasia, late-onset sepsis, postnatal steroid therapy and male gender. The presence of severe abnormalities on brain ultrasound scan and of an abnormal neurological assessment at 40 weeks at term equivalent age were strong predictors of poor outcome.
Conclusions:
Our study is one of the few investigating the short-term outcome of preterm VLBW Italian children born in the second half of the 2000s. Neurodevelopmental assessment at 24 months revealed a marked reduction in major sequelae. Several risk factors for a poor neurodevelopmental outcome identified in children born in earlier periods were confirmed in these children born in recent years.
