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Factors affecting neurodevelopmental outcome at 2 years in very preterm infants below 1250 grams: a prospective study

Journal of Perinatology volume 38, pages 1093–1100 (2018)Cite this article

Subjects

Abstract

Objective

To evaluate the neurodevelopmental outcomes of preterm very-low birth weight (PT/VLBW) infants at 2 years and identify risk factors associated with significant developmental delay or neurodevelopmental impairment (NDI).

Study design

We evaluated 165 PT/VLBW infants born between January 2010 and December 2011, using the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III). NDI was defined as the presence of neurosensory impairment or significant delay with Bayley-III score < 70 in any domain and risk factors for delay/NDI were assessed using logistic regressions.

Results

Median Bayley-III composite scores in the cognitive, language and motor domains were 95, 89 and 94, respectively. NDI was present in 20% of the children, with 5–18% having significant delay in either cognitive, language or motor domain, seven (4%) children had cerebral palsy, three (2%) were deaf and none were blind. Regression models identified significant positive associations of delayed cognitive skills with male gender (Odds ratio (OR) 22.4, 95% confidence interval (CI) 1.5–341.1; P = 0.025), lack of anntenatal steroids (ANS) (OR 41.5, 95% CI 3.5–485.7; P = 0.003), and hypotension needing inotropes (OR 36.0, 95% CI 2.6–506.0; P = 0.008); delayed language skills with lower maternal education (OR 3.8, 95% CI 1.4–10.3; P = 0.10), lack of ANS (OR 2.8, 95% CI 1.1–7.4; P = 0.04), and 5 minute Apgar Score ≤ 5 (OR 7.4, 95% CI 1.4–38.4; P = 0.017) and delayed motor skills with chronic lung disease at 36 weeks (OR 38.3, 95% CI 2.4–603.4; P = 0.010). NDI was associated with lack of ANS (OR 2.91, 95% CI 1.21–7.00; P = 0.02) and use of postnatal steroids (OR 3.36, 95% CI 1.07–10.54; P = 0.0374).

Conclusion

Risk factors for both NDI and individual domain delay were identified and will be helpful in planning of specific and targeted early intervention services.

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Author information

Authors and Affiliations

  1. Department of Child Development, KK Women’s and Children’s Hospital, Singapore, Singapore

    Pratibha Keshav Agarwal, Phey Hong Yang & Lourdes Mary Daniel

  2. Department of Epidemiology, Singapore Clinical Research Institute, Singapore, Singapore

    Luming Shi & Qishi Zheng

  3. Duke-NUS Medical School, Singapore, Singapore

    Luming Shi, Victor Samuel Rajadurai, Poh Choo Khoo, Bin Huey Quek & Lourdes Mary Daniel

  4. Cochrane Singapore, Singapore, Singapore

    Luming Shi & Qishi Zheng

  5. Department of Neonatology, KK Women’s and Children’s Hospital, Singapore, Singapore

    Victor Samuel Rajadurai & Bin Huey Quek

  6. Department of Psychology, National University of Singapore, Singapore, Singapore

    Phey Hong Yang

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  1. Pratibha Keshav Agarwal
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  2. Luming Shi
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  3. Victor Samuel Rajadurai
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Correspondence to Qishi Zheng.

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Agarwal, P.K., Shi, L., Rajadurai, V.S. et al. Factors affecting neurodevelopmental outcome at 2 years in very preterm infants below 1250 grams: a prospective study. J Perinatol 38, 1093–1100 (2018). https://doi.org/10.1038/s41372-018-0138-3

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