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School Performance and Neurodevelopment of Very Low Birth Weight Preterm Infants: First Report From Turkey
Özden Koç1, Sultan Kavuncuoğlu2, Mehmet G Ramoğlu3
1Department of Pediatrics, Bakırköy Gynecology & Obstetrics and Children's Education Hospital, İstanbul, Turkey.
Insights
Very low birth weight preterm infants face risks. Early neurodevelopmental assessments, like the Wechsler Intelligence Scale for Children-Revised (WISC-R), identify cognitive issues and guide interventions for better school performance.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Neuroscience
Background:
- Infants born with very low birth weight or preterm are at high risk for adverse neurologic, developmental, and somatic outcomes.
- Early identification of neurodevelopmental deficits is crucial for timely intervention and improved long-term prognosis.
Purpose of the Study:
- To assess the neurodevelopmental outcomes of very low birth weight preterm infants after their first year of elementary school.
- To identify factors correlating with neurodevelopmental status in this high-risk population.
Main Methods:
- A cohort of 90 infants (birth weight <1500 g and/or gestational age <32 weeks) was evaluated.
- Neurodevelopment was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R), Pediatric Symptom Checklist, and Parent Evaluation of Developmental Status.
- Incidence of specific morbidities like mental retardation and cerebral palsy was recorded.
Main Results:
- 14% experienced mental retardation, 7% cerebral palsy, 2% blindness, 5% epilepsy, and 2% posthemorrhagic hydrocephalus.
- 35.5% of infants scored below 85 on the WISC-R.
- Perinatal asphyxia, abnormal neurologic exams, and speech delays significantly correlated with lower WISC-R scores.
- Higher paternal education and income positively impacted WISC-R scores.
Conclusions:
- A significant proportion of very low birth weight preterm infants exhibit neurodevelopmental deficits by early school age.
- Perinatal factors and early neurologic signs are key predictors of cognitive outcomes.
- Environmental factors and parental involvement play a vital role in school performance, highlighting the need for comprehensive support.
Abstract:
Very low birth weight preterm infants are under significant risk of neurologic, developmental, and somatic problems. In this study, 90 infants born with a birth weight <1500 g and/or with a gestational age <32 weeks were evaluated after the first year of elementary school to assess neurodevelopment. The Wechsler Intelligence Scale for Children-Revised (WISC-R) test, Pediatric Symptom Checklist, and Parent Evaluation of Developmental Status were performed. Mental retardation, cerebral palsy, blindness, epilepsy, and posthemorrhagic hydrocephaly incidences were 14%, 7%, 2%, 5%, and 2%, respectively. The WISC-R score of 32 patients (35.5%) were below 85. Perinatal asphyxia, abnormal neurologic examination, and delayed or impaired speech correlated significantly with low WISC-R scores. Education and income of the father had positive impact on WISC-R scores (P = .042 and P = .026). Parents' concern and presence of cognitive problems were correlated (P = .026). Environmental factors, as well as the prevention of morbidity, affected school performance positively.