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Published on: November 20, 2015
Risk factors and outcomes in preterm versus full-term infants with abusive head trauma: A retrospective comparative
Erin Klements1, Robin L Peterson1, William A Anastasiadis1
1Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, United States; Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, 12631 East 17th Avenue, Aurora, CO 80045, United States.
Insights
Premature birth increases abusive head trauma (AHT) risk. Age-corrected developmental scores were higher in preterm infants with AHT, despite similar demographics and family factors compared to term infants.
Area of Science:
- Pediatric Medicine
- Neurology
- Child Development
Background:
- Premature birth is a known risk factor for abusive head trauma (AHT).
- Limited research exists comparing AHT outcomes in preterm versus term infants.
- Understanding these differences is crucial for early intervention and care.
Purpose of the Study:
- To investigate demographic, family, and contextual variations between preterm and term infants diagnosed with AHT.
- To compare developmental outcomes, specifically using the Bayley Scales of Infant Development, in these two infant groups.
- To identify potential disparities in AHT presentation and prognosis based on gestational age.
Main Methods:
- A retrospective chart review was conducted on 403 AHT patients (70 preterm) treated between 2012 and 2020.
- Statistical analyses included independent samples t-tests, chi-square tests, and binary logistic regression to compare groups.
- Bayley Scales of Infant Development scores (corrected and uncorrected for gestational age) were analyzed using repeated measures ANOVA.
Main Results:
- Preterm infants exhibited significantly lower height and weight percentiles but showed no other demographic or family/contextual differences compared to term infants.
- Age-corrected Bayley scores were numerically higher in preterm infants than term infants.
- Significant increases in corrected versus uncorrected Bayley scores were observed in preterm infants across Cognitive, Expressive Language, Fine Motor, and Gross Motor domains.
Conclusions:
- No significant demographic or family/contextual differences were found between preterm and term infants with AHT.
- Age-corrected developmental assessments reveal higher performance in preterm infants with AHT compared to uncorrected scores.
- These findings highlight the importance of gestational age correction when evaluating developmental outcomes in preterm infants affected by AHT.
Background:
Premature birth is a risk factor for abusive head trauma (AHT), but no prior studies have compared preterm and term infants with AHT.
Objective:
To assess differences in demographics, family/contextual factors, and outcomes between preterm and term infants with AHT.
Participants And Setting:
403 patients (70 preterm) treated for AHT between 2012 and 2020 at a tertiary care children's hospital.
Methods:
Data were collected via chart review. Demographics, family/contextual variables, and a composite score for each Bayley Scales of Infant Development domain were compared between preterm and term patients with independent samples t-tests, chi-square tests, and binary logistic regression. Gestational age (GA) corrected and uncorrected Bayley scores for preterm patients were compared using a repeated measures ANOVA.
Results:
Preterm infants had significantly lower height (p < .001, d = 0.50) and weight (p < .001, d = 0.44) percentiles, but no other significant demographic or family/contextual differences were found. Preterm children earned numerically higher Bayley scores than term infants with GA correction and lower scores without correction. Corrected Bayley scores were significantly higher than uncorrected for preterm infants in the Cognitive (p < .001, η2p = 0.083), Expressive Language (p = .005, η2p = 0.052), Fine Motor (p = .001, η2p = 0.045), and Gross Motor (p = .008, η2p = 0.031) domains.
Conclusions:
While no significant differences in demographics or family/contextual variables were observed, age corrected Bayley scores were significantly higher than uncorrected scores for preterm infants with AHT.
