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Longitudinal study of neuropsychological outcome in blind extremely-low-birthweight children
A Gosch1, M Brambring, H Gennat
1Research Center for Prevention and Intervention in Childhood and Adolescence, University of Bielefeld, Germany.
Insights
Extremely low birthweight (ELBW) blind children experienced more complications and poorer neurological and psychological development compared to term-born blind children. These developmental outcomes correlated with factors like gestational age and birthweight.
Area of Science:
- Developmental Pediatrics
- Neonatology
- Ophthalmology
Background:
- Blindness in infancy can stem from various causes, including retinopathy of prematurity.
- Extremely low birthweight (ELBW) infants face heightened risks for developmental challenges.
- Longitudinal studies are crucial for understanding the developmental trajectories of blind children, particularly those with ELBW.
Purpose of the Study:
- To compare the neurological and psychological development of blind children born extremely low birthweight (ELBW) with those born at term.
- To identify factors influencing developmental outcomes in blind infants and preschoolers.
Main Methods:
- A 4-year longitudinal study of 10 blind children (5 ELBW, 5 term).
- Neurological examinations were conducted annually, starting at 10 months.
- The Bielefeld Developmental Test for Blind Infants and Preschoolers (BDTB) was administered biannually from 18 to 48 months.
Main Results:
- Blind ELBW children exhibited more peri- and neonatal complications and neurological symptoms.
- At nearly 5 years old, blind ELBW children had significantly lower anthropometric measurements (weight, height, head circumference, BMI).
- Blind ELBW children scored significantly lower on all BDTB developmental domains.
Conclusions:
- ELBW is associated with poorer neurological and psychological development in blind children.
- Gestational age, birthweight, mechanical ventilation duration, and hospitalization length are significant predictors of developmental outcomes.
- Early identification and intervention are critical for improving developmental trajectories in vulnerable blind populations.
Abstract:
This study evaluated neurological and psychological development in 10 blind children over a 4-year period. Five of the children were born preterm with an extremely low birthweight (ELBW) and a diagnosis of retinopathy, whereas the other five were term. All children received their first neurological examination at a mean age of 10 months and then annual follow ups. In addition, the Bielefeld Developmental Test for Blind Infants and Preschoolers (BDTB) was administered every 6 months (from the ages of 18 to 48 months) to assess developmental outcome in different domains (e.g. cognition, language, gross motor abilities). Results showed a higher number of peri- and neonatal complications in blind ELBW children as well as a significantly higher number of neurological symptoms over the 4-year period. At the mean age of 4 years 10 months, blind ELBW children had a significantly lower body weight, body height, head circumference, and body-mass index compared with the term children. Findings on psychological development revealed that blind ELBW children also had significantly lower scores on all domains covered by the BDTB. Finally, the overall score on the BDTB correlated significantly with gestational age, birthweight, duration of mechanical respiration, and days spent in hospital after delivery.