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Intellectual outcomes of extremely preterm infants at school age

Maya Asami1, Atsushi Kamei1, Misato Nakakarumai1

  • 1Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|December 10, 2016
PubMed

Insights

Improved survival for extremely preterm infants is linked to a higher rate of intellectual impairment. Key factors include supplemental oxygen, longer hospital stays, intraventricular hemorrhage, and delayed feeding, highlighting areas for improved long-term outcomes.

Area of Science:

  • Neonatal care
  • Developmental pediatrics
  • Perinatal medicine

Background:

  • Survival rates for extremely preterm (EP) infants (<28 weeks gestation) have significantly improved.
  • Long-term prognosis and neurodevelopmental outcomes for EP infants are of increasing interest.
  • This study investigates the impact of prenatal and postnatal care on intellectual development in EP infants.

Purpose of the Study:

  • To determine the influence of prenatal and postnatal care on long-term intellectual outcomes in extremely preterm infants.
  • To analyze changes in survival rates and neurodevelopmental outcomes over two distinct time periods.
  • To identify risk factors associated with intellectual impairment in this vulnerable population.

Main Methods:

  • Analysis of extremely preterm infants admitted to the NICU between 1982 and 2005.
  • Comparison of survival and neurodevelopmental outcomes at 6 years of age between 1982-1991 (period 1) and 1992-2005 (period 2).
  • Logistic regression analysis to identify risk factors for intellectual impairment.

Main Results:

  • Survival rate increased from 84.5% to 92.4% between period 1 and period 2.
  • Incidence of intellectual impairment rose from 16.3% to 31.0% in the same periods.
  • Risk factors for intellectual impairment included later care period, supplemental oxygen, prolonged hospitalization, intraventricular hemorrhage (IVH), and delayed feeding.

Conclusions:

  • Despite improved survival, extremely preterm infants face an increased risk of intellectual impairment.
  • Reducing chronic lung disease, apnea, IVH, and nutritional deficits are crucial for enhancing intellectual outcomes.
  • Targeted interventions focusing on these risk factors are essential for improving long-term neurodevelopment in EP infants.
Abstract

Keywords:
extremely preterm infantfollow-up studyoutcome studyrisk factor

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