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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental Changes and Postnatal Growth in the First 3 Years of Extremely Preterm Infants
Yuka Matsunaga1,2,3, Hirosuke Inoue4,5, Yuta Miyauchi4,5
1Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, kishiped@yahoo.co.jp.
Insights
Growth in height, male sex, and having siblings impact neurodevelopmental changes in extremely preterm infants. Perinatal complications were not linked to these changes. This highlights key factors influencing infant development trajectories.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Neuroscience
Background:
- Extremely preterm infants face significant risks for neurodevelopmental problems.
- Neurodevelopmental trajectories in this population are highly variable.
- Understanding factors influencing these trajectories is crucial for early intervention.
Purpose of the Study:
- To investigate the association between clinical characteristics and changes in neurodevelopmental outcomes.
- To identify predictors of neurodevelopmental changes in extremely preterm infants.
Main Methods:
- Retrospective study of surviving infants born between 22-28 weeks gestational age.
- Collected perinatal and post-discharge data.
- Analyzed changes in developmental quotient (DQ) scores from 1.5 to 3 years corrected age.
Main Results:
- 33% of infants showed improved DQ scores, 54% had no change, and 17% declined.
- Gestational age, birth weight, and perinatal complications did not predict DQ score changes.
- Height growth, male sex, and sibling status were significant predictors of DQ score changes.
Conclusions:
- Height growth, male sex, and sibling status are biologically linked to neurodevelopmental changes in extremely preterm infants.
- These factors, rather than perinatal complications, influence neurodevelopmental trajectories in the first three years.
- Findings offer insights into factors affecting neurodevelopmental outcomes in this vulnerable group.
Introduction:
Infants born extremely preterm are at high risk for neurodevelopmental problems. However, their neurodevelopment exhibits a variety of trajectories. This study aimed to investigate the association between changes in neurodevelopmental outcomes and clinical characteristics among extremely preterm infants.
Methods:
This is a retrospective study of surviving children born at gestational age 22-28 weeks in Kyushu University Hospital between 2010 and 2020. We collected perinatal and post-discharge data and investigated the association between clinical characteristics and changes in developmental quotient (DQ) scores between 1.5 and 3 years of corrected age.
Results:
Out of the 179 eligible extremely preterm infants, 115 (64%) underwent neurological evaluations at 1.5 and 3 years of corrected age. Among them, 33 (29%) showed improvement in their DQ scores (+10 or more), 62 (54%) showed no change (-9 to +9), and 20 (17%) showed a decline (-10 or less). Gestational age, birth weight, and perinatal complications during the NICU stay did not affect individual changes in DQ scores. Multivariable analysis revealed that greater growth in height until age 3 years was a significant predictor of increasing DQ scores, while male sex and having siblings had a negative effect on changes in the DQ scores.
Conclusion:
We first demonstrate clinical data conceptualizing that growth in height, sex, and sibling status, rather than perinatal complications, are biologically linked with favorable or unfavorable neurodevelopmental changes of extremely preterm infants during the first 3 years of life.
