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Published on: February 18, 2012
Neurological Surveillance in Moderate-Late Preterm Infants-Results from a Dutch-Canadian Survey
Martine F Krüse-Ruijter1, Vivian Boswinkel1, Anna Consoli2
1Department of Neonatology, Isala Women and Children's Hospital, 8025 AB Zwolle, The Netherlands.
Insights
Neurological surveillance practices for moderate-late preterm infants (32-36 weeks) vary widely in Dutch and Canadian neonatal centers. Further research is needed to establish best practices for their care and follow-up.
Area of Science:
- Neonatal care
- Neurodevelopmental pediatrics
- Public health
Background:
- Preterm birth is a significant risk factor for abnormal neurodevelopment.
- Moderate-late preterm infants (32-36 weeks gestation) represent the majority of preterm births.
- Current international and national guidelines for neurological surveillance in this population are insufficient.
Purpose of the Study:
- To investigate current clinical practices for neurological surveillance in moderate-late preterm infants.
- To identify variations in care protocols across neonatal centers.
Main Methods:
- An observational, quantitative survey was conducted among Dutch and Canadian neonatal centers (June 2020-August 2021).
- Neonatal centers (level I-III) were invited to participate, with one pediatrician/neonatologist completing the survey.
- Data collected included admission criteria, use of cranial ultrasonography, neurological examinations, and post-discharge follow-up practices.
Main Results:
- A total of 85 out of 174 centers (49%) completed the survey.
- Most admissions (92%) were based on infant-related criteria.
- Cranial ultrasonography was routine in 19% and on indication in 46% of centers.
- Neurological examinations were performed in 67% of centers during admission.
- Post-discharge follow-up occurred in 60% of centers, with variable durations (1-52 months).
Conclusions:
- Significant variability exists in the neurological surveillance of moderate-late preterm infants across Dutch and Canadian neonatal centers.
- The findings highlight the need for standardized best practices for in-hospital care and long-term follow-up.
- Further research is warranted to address the neurodevelopmental risks associated with moderate-late preterm birth.
Abstract:
Preterm birth remains an important cause of abnormal neurodevelopment. While the majority of preterm infants are born moderate-late preterm (MLPT; 32-36 weeks), international and national recommendations on neurological surveillance in this population are lacking. We conducted an observational quantitative survey among Dutch and Canadian neonatal level I-III centres (June 2020-August 2021) to gain insight into local clinical practices on neurological surveillance in MLPT infants. All centres caring for MLPT infants designated one paediatrician/neonatologist to complete the survey. A total of 85 out of 174 (49%) qualifying neonatal centres completed the survey (60 level I-II and 25 level III centres). Admission of MLPT infants was based on infant-related criteria in 78/85 (92%) centres. Cranial ultrasonography to screen the infant's brain for abnormalities was routinely performed in 16/85 (19%) centres, while only on indication in 39/85 (46%). In 57/85 (67%) centres, neurological examination was performed at least once during admission. Of 85 centres, 51 (60%) followed the infants' development post-discharge, with follow-up duration ranging from 1-52 months of age. The survey showed a wide variety in neurological surveillance in MLPT infants among Dutch and Canadian neonatal centres. Given the risk for short-term morbidity and long-term neurodevelopmental disabilities, future studies are required to investigate best practices for in-hospital care and follow-up of MLPT infants.
