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Neonatal hyperviscosity association with lower achievement and IQ scores at school age
V Delaney-Black1, B W Camp, L O Lubchenco
1Department of Pediatrics, Wayne State University, Children's Hospital of Michigan, Detroit 48201.
Insights
Children with neonatal polycythemia and hyperviscosity showed persistent deficits in spelling, arithmetic, and gross motor skills into school age. These findings highlight the long-term impact of neonatal hyperviscosity on neurodevelopment.
Area of Science:
- Pediatric Neurology
- Neonatal Medicine
- Developmental Psychology
Background:
- Neonatal polycythemia and hyperviscosity are associated with early neurologic and motor impairments.
- The long-term persistence of these deficits into school age requires further investigation.
Purpose of the Study:
- To determine if early neurologic and motor impairments in children with neonatal polycythemia and hyperviscosity persist into school age.
- To compare outcomes between children treated with partial plasma exchange transfusion and those receiving symptomatic care.
Main Methods:
- A longitudinal study evaluated 49 children with neonatal polycythemia/hyperviscosity and 40 controls at age 7.
- Neuropsychological testing included IQ, achievement, neuromotor, and motor skills assessments.
- Maternal education and IQ were assessed as covariates.
Main Results:
- Children with neonatal hyperviscosity (n=49) had significantly lower spelling, arithmetic, and gross motor scores at age 7 compared to controls (n=40).
- No significant differences were found in reading, visual motor integration, or neurologic signs.
- Multivariate analysis confirmed significant differences in cognitive and motor functions (P = .040).
Conclusions:
- Neonatal polycythemia and hyperviscosity are associated with persistent deficits in academic achievement and gross motor skills into school age.
- Partial plasma exchange transfusion did not show a significant difference in outcomes compared to symptomatic care in this cohort.
- These findings underscore the importance of monitoring neurodevelopmental outcomes in children with a history of neonatal hyperviscosity.
Abstract:
A longitudinal study was conducted to determine whether the early neurologic and motor impairment observed in children with neonatal polycythemia and hyperviscosity persisted into school age. Forty-nine children who had neonatal polycythemia and hyperviscosity were evaluated at a mean age of 7 years. Of these, 21 (group 1) received a partial plasma exchange transfusion, whereas 28 (group 2) received symptomatic care. Forty control children (group 3) with a normal neonatal hematocrit were also evaluated. Testing consisted of a battery of measures to evaluate IQ, achievement, neuromotor function, and gross and fine motor skills. Maternal education and IQ were also assessed to avoid potential confounding by differences in the home environment. The neonatal course of the children with polycythemia and hyperviscosity was characterized by an increased number of problems, including hypoglycemia and cyanosis. At 7 years of age, the 49 children who had hyperviscosity (groups 1 and 2) had significantly lower "spelling" and arithmetic achievement test results and gross motor skill scores. Scores for reading, visual motor integration, and neurologic signs did not differ significantly from group 3. Maternal IQ scores were similar for both groups. Left-hand preference was seen in 14% of group 1 and 2 children and 7% of group 3 children (not significant). The scores for IQ, achievement, neuromotor function, and visual motor integration were compared for the hyperviscosity group (groups 1 and 2) and the control group (group 3) by multivariate analysis of variance with sex and hyperviscous group as independent variables and maternal education and maternal IQ as covariates (P = .040).(ABSTRACT TRUNCATED AT 250 WORDS)