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Published on: November 20, 2015
Neurodevelopment in preterm infants with and without placenta-related intrauterine growth restriction and its
Júlia Candel-Pau1,2,3, Josep Perapoch López2,3, Félix Castillo Salinas2,3
1a Vall d'hebrón Research Institute (VHIR), Vall d'hebron University Hospital, Universitat Autònoma de Barcelona , Barcelona , Spain .
Insights
Placenta-related intrauterine-growth restriction (IUGR) did not significantly impact preschool neurodevelopment in preterm infants. Positive postnatal factors like parental education and breastfeeding improved outcomes.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Obstetrics
Background:
- Intrauterine-growth restriction (IUGR) is linked to neurodevelopmental issues.
- Research on early childhood neurodevelopment in premature infants with placenta-related IUGR is limited and varied.
Purpose of the Study:
- To investigate the effect of placenta-related IUGR on neurodevelopment in preterm infants at preschool age.
- To identify prenatal and postnatal factors influencing neurodevelopment in this population.
Main Methods:
- A prospective cohort study compared 48 preterm infants with placenta-related IUGR to 25 matched preterm infants without IUGR.
- Neurodevelopment was assessed using cognitive Bayley Scales III and ASQ-III surveys between 34 and 42 months corrected age.
- Perinatal and environmental factors were analyzed for their association with neurodevelopmental outcomes.
Main Results:
- No significant differences in preschool neurodevelopment were found between the IUGR and non-IUGR preterm groups.
- Multivariate analysis indicated that daycare, breastfeeding, higher parental education, and absence of severe neonatal morbidity were associated with a lower risk of altered neurodevelopment.
Conclusions:
- Placenta-related IUGR did not significantly affect preschool neurodevelopment in the studied preterm infants.
- Positive postnatal environmental factors, including parental education, breastfeeding, and daycare, are crucial for improving neurodevelopment in these infants.
Objective:
Intrauterine-growth restriction is associated with impaired neurodevelopment. However, studies on early childhood neurodevelopment of premature infants with placenta-related intrauterine-growth restriction (IUGR) are scarce and heterogeneous. We aimed to analyze the impact of placenta-related IUGR on preschool age neurodevelopment in preterm infants, and to ascertain which prenatal and postnatal factors influence neurodevelopment in these infants.
Methods:
Prospective cohorts study: 48 placenta-related IUGR premature infants and 25 matched non-IUGR premature infants (mean gestational age: 31.4 and 31.6 weeks, respectively). Preschool neurodevelopment assessment with cognitive Bayley Scales III and with ASQ-III surveys (age interval: 34.07-42.50 months). Inter-cohort result comparison. Analysis of perinatal and environmental factors associated with impaired neurodevelopment in both cohorts.
Results:
No statistically significant neurodevelopment differences were observed at preschool age between both preterm cohorts. Multivariate analysis of perinatal and environmental factors showed daycare, breastfeeding, higher parental educational level, and absence of severe neonatal morbidity to be associated with a lower risk of altered neurodevelopment at preschool age.
Conclusions:
Placenta-related IUGR does not have a significant impact on preschool neurodevelopment in our preterm patients. Instead, post-natal positive environmental factors such as parental educational level, breastfeeding, and daycare attendance make a difference towards an improvement in neurodevelopment in these infants.
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