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Psychomotor and Cognitive Outcome in Very Preterm Infants in Vorarlberg, Austria, 2007-2019
Fabio Jenni1, Karin Konzett1, Stefanie Gang1
1Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria.
Insights
Neurodevelopmental outcomes for very and extremely preterm infants in Austria are favorable, with low adverse rates comparable to international data. Further research into social and environmental factors is recommended for cognitive and language development.
Area of Science:
- Neonatal care and developmental pediatrics
- Perinatal health outcomes
- Infant neurodevelopmental assessment
Background:
- Preterm birth presents significant risks for infant neurodevelopmental outcomes.
- Assessing neurodevelopmental trajectories in very and extremely preterm infants is crucial for early intervention.
- Regional variations in healthcare and outcomes necessitate localized studies.
Purpose of the Study:
- To evaluate the neurodevelopmental status of very and extremely preterm infants at 24 months corrected age in Vorarlberg, Austria.
- To compare local neurodevelopmental outcomes with international benchmarks.
- To identify perinatal factors influencing neurodevelopmental outcomes in this cohort.
Main Methods:
- Retrospective, population-based multicenter study of preterm infants born between 2007-2019.
- Neurodevelopmental assessment using Bayley Scales of Infant Development (BSID-II/Bayley-III) at 24 months corrected age.
- Analysis of perinatal data including gestational age, birth weight, and specific medical conditions.
Main Results:
- Mean Mental Developmental Index (MDI) was 91 and Psychomotor Developmental Index (PDI) was 99.6, with adverse outcomes (<70) in 15.5% (MDI) and 4.2% (PDI).
- Extremely preterm infants showed similar PDI (100.1) but slightly lower MDI (88.4), with higher adverse rates (20.3% MDI, 5.1% PDI).
- Bronchopulmonary dysplasia, intraventricular hemorrhage, head circumference, and patent ductus arteriosus were significant risk factors for adverse outcomes.
Conclusions:
- Preterm infants in Vorarlberg exhibit favorable neurodevelopmental outcomes, aligning with international standards.
- The study highlights the importance of monitoring specific perinatal factors to predict and mitigate adverse neurodevelopmental outcomes.
- Future research should investigate the impact of social and environmental factors on cognitive and language development in preterm infants.
Aim:
The aim of this study was to analyze neurodevelopmental outcome of very and extremely preterm infants in Vorarlberg, Austria, accessed with neurodevelopmental testing, at the corrected age of 24 months. This article also compared these results with (inter)national data and analyzed the impact of perinatal parameters.
Methods:
Population-based, retrospective multicenter study with data on very and extremely preterm infants born in Vorarlberg from 2007 to 2019 assessed with Bayley Scales of Infant Development (BSID-II/Bayley-III).
Results:
Included were 264 infants with a mean age of 29.0 (± 2.1) weeks of gestational age and a mean birth weight of 1177 (± 328.26) g; 172 infants underwent a BSID-II, 92 a Bayley-III assessment. The psychomotor developmental index (PDI) and mental developmental index (MDI) showed mean scores of 99.6 (± 14.4) and 91 (± 20.4), respectively. Adverse outcomes (scores <70) were assessed in 4.2% for PDI and 15.5% for MDI. In the extremely preterm group (n = 79), results for mean PDI were 100.1 (± 16.8) and for mean MDI 88.4 (± 22.4). Accordingly, adverse outcomes were assessed in 5.1% for PDI and in 20.3% for MDI. In addition to bronchopulmonary dysplasia and intraventricular hemorrhage Grade 3-4, head circumference at birth and patent ductus arteriosus were also identified as risk factors for poor outcome.
Conclusion:
This study showed a remarkably good neurodevelopmental outcome in preterm infants with low rates of adverse outcome, similar to (inter)national reports, especially in the group of extremely preterm infants. Research is needed to explore the role of social factors and infants' environment, especially cognitive outcome and language skills.
