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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Five-Year Neurodevelopmental Outcome of Children Born Very Preterm Between 2012 and 2018
Verena M Sparr1, Caroline F Willwohl1, Barbara Fussenegger1
1Department of Pediatrics and Adolescent Medicine, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria.
Insights
Most very preterm children (65.7%) had no neurodevelopmental disability at age 5. However, extremely preterm infants faced worse outcomes, with abnormal hearing, male gender, and severe ICH linked to poorer cognitive and motor skills.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Public Health
Background:
- Preterm birth is a major risk factor for neurodevelopmental impairments.
- Understanding long-term outcomes and identifying risk factors in preterm populations is crucial for early intervention.
Purpose of the Study:
- To analyze the neurodevelopmental outcomes of children born very preterm at 5 years of age in Vorarlberg, Austria.
- To identify medical risk factors associated with these outcomes.
- To compare findings with national and international data.
Main Methods:
- Population-based study with prospectively collected data.
- Neurodevelopmental assessment using Kaufman Assessment Battery for Children (KABC-II), Movement Assessment Battery for Children (M-ABC-2), Strengths and Difficulties Questionnaire (SDQ), and Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P).
- Multiple linear regression analysis to identify risk factors.
Main Results:
- 2.9% of very preterm children exhibited moderate to severe neurodevelopmental disability; 65.7% had no disability.
- Children born extremely preterm showed more disadvantageous outcomes than very preterm children.
- Abnormal hearing screening, male gender, and ICH grades 3-4 were associated with poorer cognitive and motor skills.
Conclusions:
- A small proportion of very preterm children experience moderate to severe neurodevelopmental disabilities by age 5.
- Early identification of risk factors like abnormal hearing, male gender, and severe intracranial hemorrhage is vital for targeted support.
- Outcomes are more challenging for extremely preterm infants, necessitating specialized care pathways.
Abstract:
To analyze neurodevelopmental outcome of children born very preterm (born 2012 to 2018) aged 5 years in Vorarlberg, Austria. To identify medical risk factors and compare with (inter)national data.In this population-based study with prospectively collected data very preterm children underwent neurodevelopmental assessment: Kaufman Assessment Battery for Children (KABC-II) for cognitive functioning, Movement Assessment Battery for Children (M-ABC-2) for motor skills, Strengths and Difficulties Questionnaire (SDQ) and Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P) for deficits in behavior and executive functions. Risk factors were identified using multiple linear regression.The study population (n = 114, 46.5% completed follow-up) showed moderate to severe neurodevelopmental disability (KABC-II IQ score <70), mild (KABC-II IQ score 70-84, M-ABC-2 total score <7, SDQ total score >90th percentile or BRIEF-P Global Executive Function score T >65), and no neurodevelopmental disability in 2.9, 31.4, and 65.7% of the children, respectively. Results were more disadvantageous for children born extremely preterm than for very preterm born children. Regarding risk factors, abnormal hearing screening, male gender, and ICH grades 3-4 were associated with poorer cognitive and motor skills.In our state-wide cohort of very preterm children, we observed a small proportion of moderate to severe neurodevelopmental disabilities of 2.9%, whereby 65.7% had no disability at 5 years. Disadvantageous outcomes are more pronounced in extremely preterm children.
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