[Prognosis of intensively treated newborns: psychomotor development during the first years of life]
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Neonatal intensive care unit (NICU) survivors at high risk for abnormal symptoms showed a 5% incidence of cerebral palsy by 15 months. Symptoms decreased with age, but convulsions indicated a poorer prognosis.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Developmental Pediatrics
Context:
- Neonatal intensive care unit (NICU) survivors face risks for long-term neurological deficits.
- Assessing neurodevelopmental outcomes in high-risk infants is crucial for early intervention.
- Previous studies have varied in reported incidence rates of abnormal neuromotor symptoms.
Purpose:
- To determine the incidence of abnormal cerebromotor symptoms in high-risk neonatal intensive care unit (NICU) survivors.
- To evaluate the relationship between postnatal age and the development of these symptoms.
- To estimate the prevalence of cerebral palsy in a general pediatric population based on NICU outcomes.
Summary:
- A follow-up study of 287 high-risk neonatal intensive care unit (NICU) survivors (out of 616) from Berne University Children's Hospital (1974-1976) was conducted.
- At a mean age of 15 months, 10% exhibited clear-cut and 24% slight abnormal cerebromotor symptoms.
- This translates to an estimated 5% incidence of cerebral palsy in the overall pediatric population, with symptoms decreasing significantly with increasing postnatal age, though neonatal convulsions predicted a less favorable outcome.
Impact:
- Provides an estimated cerebral palsy incidence of 5% at 15 months for the general pediatric population, comparable to existing figures.
- Highlights the importance of continued neurodevelopmental surveillance for high-risk infants.
- Identifies neonatal convulsions as a significant risk factor for adverse neurodevelopmental outcomes, guiding clinical management and prognosis.
Abstract:
330 out of 616 surviving newborns treated in the neonatal ICU of Berne University Children's Hospital from 1.1 1974 to 31.12. 1976 were considered, on the basis of strict criteria, to be especially at risk for the development of abnormal cerebromotor symptoms, 287 were followed up. At age 3--42 (mean 15) months, 10% of these especially endangered children showed clear-cut, and 24% slightly abnormal, symptoms. If related to the total number of surviving patients, all of whom were either ill or at risk for disturbed neonatal adaptation, this corresponds to 5 and 11% respectively. Based on this population, an approximate incidence of cerebral palsy of 5% at age 15 months can be calculated for the whole pediatric population. This value is comparable to the 2% actually found in the total pediatric population. Furthermore, a statistically significant decrease in abnormal symptoms with increasing postnatal age was found. Newborns with convulsions, however, do not have this favourable prognosis.