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Functional outcome at school age of neonatal post-hemorrhagic ventricular dilatation
Janyte C Holwerda1, Koenraad N J A Van Braeckel1, Elise Roze1
1Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Insights
Children with post-hemorrhagic ventricular dilatation (PHVD) experience deficits in intelligence, attention, and visual perception at school age. Surgical intervention in PHVD cases was linked to lower IQ scores.
Area of Science:
- Pediatrics
- Neonatology
- Neurodevelopmental Disorders
Background:
- Functional outcomes for preterm children with post-hemorrhagic ventricular dilatation (PHVD) are not well-established.
- PHVD is a serious complication in preterm infants, potentially impacting long-term development.
Purpose of the Study:
- To assess the school-age functional outcomes of children with PHVD.
- To identify specific PHVD characteristics associated with increased risk for developmental deficits.
Main Methods:
- A single-center case-control study included preterm children with PHVD and matched controls.
- Standardized tests assessed intelligence, attention, memory, executive function, perception, motor skills, and behavior at school age.
- Outcomes were compared between the PHVD group and controls, with subgroup analysis for surgical intervention.
Main Results:
- Children with PHVD showed significantly lower total and verbal IQ scores compared to controls.
- The PHVD group performed worse on tests of visual perception and attention, with a trend toward attention deficits.
- Within the PHVD group, those who underwent surgical intervention had significantly lower total IQ scores.
Conclusions:
- Preterm children with PHVD exhibit impaired intelligence, attention, and visual perception at school age.
- Surgical intervention for PHVD is associated with poorer intellectual outcomes.
- Further research is needed to understand the long-term neurodevelopmental trajectory and management of PHVD.
Background:
Specific knowledge about the functional outcome of preterm born children with post-hemorrhagic ventricular dilatation (PHVD) is lacking.
Objectives:
To determine functional outcome at school age in children with post-hemorrhagic ventricular dilatation and to identify whether PHVD characteristics increased the risk for deficits.
Methods:
Single-center case-control study. Included were preterm children born between 1996 and 2003 who had PHVD in their neonatal period. The controls were children matched for gestation, gender, and year of birth. At school age, using standardized tests and questionnaires, we assessed intelligence, attention, verbal memory, executive functioning, visual perception, visuomotor integration, motor skills, and behavior.
Results:
Of 34 children with PHVD 28 survived, three of whom could not be tested at school age (one child's parents declined and two were lost to follow-up). At a mean age of 10years (6-14years) the total and verbal IQs of the remaining 25 children (17 boys, 8 girls) were significantly lower compared to controls (difference in total IQ-14 points, verbal IQ-9 points, P=0.001and P=0.009, respectively). After adjustment for possible confounders, the performance of the PHVD group was poorer on visual perception and attention tests. Selective attention showed a trend toward risk of borderline and abnormal scores (OR 4.03, 95%-CI 0.84-19.2). Within the PHVD group, total IQ was significantly lower (P=0.048) in those who had undergone surgical intervention (n=12).
Conclusion:
At school age, intelligence, attention, and visual perception were more affected in the PHVD group than in the matched controls. Surgical intervention was associated with lower IQ scores.
