Prolonged Mechanical Ventilation and Intracranial Hemorrhage: Impact on Developmental Progress Through 18 Months in Infants Weighing 1,200 Grams or Less at Birth

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 670-676 ◽  
Author(s):  
Mary Ellen A. Bozynski ◽  
Michael N. Nelson ◽  
Terence A. S. Matalon ◽  
Karen J. O'Donnell ◽  
Patricia M. Naughton ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intracranial Hemorrhage ◽  
Prolonged Mechanical Ventilation ◽  
Psychomotor Development ◽  
Prospective Longitudinal Study ◽  
Development Index ◽  
Psychomotor Development Index ◽  
Developmental Progress ◽  
Main Effect ◽  
Prospective Longitudinal

In this prospective, longitudinal study, the relative impact of intracranial hemorrhage and prolonged mechanical ventilation on developmental progress during the first 18 months of life of infants weighing 1,200 g or less at birth was examined. A total of 159 surviving infants were divided into two groups: infants with and those without intracranial hemorrhage. These groups were then subdivided into groups of infants receiving prolonged mechanical ventilation (> 21 days) and those mechanically ventilated for 21 days or less, thus creating four subgroups. Group 1 (intracranial hemorrhage and prolonged mechanical ventilation) and group 3 (intracranial hemorrhage and no prolonged mechanical ventilation) showed no statistically significant differences for severity of intracranial hemorrhage, persistence of yentriculomegaly, or presence of periventricular leukomalacia. A repeated-measures analysis of variance demonstrated a main effect for prolonged mechanical ventilation on outcome as measured by the Bayley Mental Development Index and Bayley Psychomotor Development Index at 4, 8, 12, and 18 months of age (corrected for prematurity). Forward stepwise regression revealed prolonged mechanical ventilation to be the best predictor of Bayley indexes at all ages except 4 months of age, for which the Psychomotor Development Index was best predicted by length of hospitalization. No main effect for intracranial hemorrhage was demonstrated, but the motor performance of infants with intracranial hemorrhage declined significantly with age. By contrast prolonged mechanical ventilation was associated with uniformly poor performance at every age and serves as a powerful marker for poor developmental progress during the first 18 months of life in infants weighing 1,200 g or less at birth.

DOZ047.81: Neurodevelopmental outcome in infants with AE: developmental trajectories in the first year of life

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
F Bevilacqua ◽  
B Ragni ◽  
L Valfrè ◽  
A Conforti ◽  
A Braguglia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Motor Development ◽  
Developmental Trajectories ◽  
Neurodevelopmental Outcome ◽  
First Year ◽  
Neurodevelopmental Outcomes ◽  
Prospective Longitudinal Study ◽  
First Year Of Life ◽  
Prospective Longitudinal

Abstract Background Esophageal atresia (EA) prognosis have improved significantly over the past three decades. Research and clinical attention has shifted to neurodevelopmental outcomes and quality of life. Aim The aim of this study wasto examine neurodevelopmental outcomes and to identify clinical and sociodemographic risk factors in a cohort of infants with EA. Methods An observational prospective longitudinal study was conducted between 2009 and 2017. Neurodevelopment was assessed at 6 and 12 months by Bayley Scales of Infants and Toddler Development—3rd Edition. Clinical and sociodemographic variables included were gender, birthweight, gestational age, associated malformations, number of hospitalizations, surgeries and dilatations at 12 months, days of mechanical ventilation, parental age, education level, and socioeconomic status. Results Ninety-six infants were enrolled in the study at 6 months and 73 of them were evaluated also at 12 months. Analysis showed significant differences between motor development at 6 and 12 months (M6 = 95.39, SD = 15.71; M12 = 91.83, SD = 12.87; t = 0.245, P = 0.017); significant differences emerged also between cognitive development at 6 and 12 months (M6 = 91.80, SD = 11.70; M12 = 100.92, SD = 15.39; t = −5.10, p = .000). Infants with long-gap AE achieved the worst scores in cognitive (r = -.28, P < .01) and motor scales (r = -.36, P < .01) at 6 months and in motor scale at 12 months (r = −0.30, P < 0.05). More days of mechanical ventilation were related to a lower score in both the cognitive (6 months r = −0.26, P < 0.05; 12 months r = −0.26, P < 0.05) and motor scale (6 months: r = −0.38, P < 0.01; 12 months r = −0.42, P < 0.01). A major number of interventions in the first year of life were related to lower scores in the motor scale at 12 months (r = −0.43, P < 0.01). Conclusions Infants operated on for AE are at risk of neurodevelopmental impairment in the first year of life. Findings support the association between neurodevelopmental outcomes and clinical risk factors. Careful interdisciplinary follow-up is essential for early detection of neurodevelopmental delay.

scholarly journals The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants

2019 ◽  
Vol 57 (1) ◽  
pp. 63-71
Author(s):  
Andrew B Goldstone ◽  
Michael Baiocchi ◽  
David Wypij ◽  
Christian Stopp ◽  
Dean B Andropoulos ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mental Development ◽  
Psychomotor Development ◽  
Absolute Difference ◽  
Systematic Bias ◽  
Development Index ◽  
Mental Development Index ◽  
Neurodevelopmental Disability ◽  
Psychomotor Development Index ◽  
Bayley Scales

Abstract OBJECTIVES Neurodevelopmental disability is the most common complication among congenital heart surgery survivors. The Bayley scales are standardized instruments to assess neurodevelopment. The most recent edition (Bayley Scales of Infant and Toddler Development 3rd Edition, Bayley-III) yields better-than-expected scores in typically developing and high-risk infants than the second edition (Bayley Scales of Infant Development 2nd Edition, BSID-II). We compared BSID-II and Bayley-III scores in infants undergoing cardiac surgery. METHODS We evaluated 2198 infants who underwent operations with cardiopulmonary bypass between 1996 and 2009 at 26 institutions. We used propensity score matching to limit confounding by indication in a subset of patients (n = 705). RESULTS Overall, unadjusted Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores (90.7 ± 17.2 vs 77.6 ± 18.8, P &lt; 0.001), and unadjusted Bayley-III composite cognitive and language scores were higher than BSID-II Mental Development Index scores (92.0 ± 15.4 vs 88.2 ± 16.7, P &lt; 0.001). In the propensity-matched analysis, Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores [absolute difference 14.1, 95% confidence interval (CI) 11.7–17.6; P &lt; 0.001] and the Bayley-III classified fewer children as having severe [odds ratio (OR) 0.24; 95% CI 0.14–0.42] or mild-to-moderate impairment (OR 0.21; 95% CI 0.14–0.32). The composite of Bayley-III cognitive and language scores was higher than BSID-II Mental Development Index scores (absolute difference 4.0, 95% CI 1.4–6.7; P = 0.003), but there was no difference between Bayley editions in the proportion of children classified as having severe cognitive and language impairment. CONCLUSIONS The Bayley-III yielded higher scores than the BSID-II and classified fewer children as severely impaired. The systematic bias towards higher scores with the Bayley-III precludes valid comparisons between early and contemporary cardiac surgery cohorts.

The Kent Infant Development Scale: Concurrent and Predictive Validity of a Modified Administration

1987 ◽  
Vol 60 (3) ◽  
pp. 887-894 ◽  
Author(s):  
Mary Morrow-Tlucak ◽  
Claire B. Ernhart ◽  
Cherie L. Liddle
Keyword(s):  
Predictive Validity ◽  
Infant Development ◽  
Predictive Ability ◽  
Psychomotor Development ◽  
Intelligence Scale ◽  
Development Index ◽  
Mental Development Index ◽  
Psychomotor Development Index ◽  
A Prospective Study ◽  
Bayley Scales

A modified administration of the Kent Infant Development Scale for infants 6 to 8 mo. old was used in a prospective study of risk factors in infant development. The Mental Development Index and Psychomotor Development Index of the Bayley Scales of Infant Development were also administered at 6 mo., the Mental Index only at 1 and 2 yr. and the Stanford-Binet Intelligence Scale at age 3. The modified administration is described. Concurrent validity with the 6-mo. Bayley scales was substantial. Adequate predictive validity for 1- and 2-yr. Bayley scores and 3-yr. Stanford-Binet IQ was achieved with the Kent as compared to the predictive ability of the 6-mo. Bayley index.

scholarly journals Bronchopulmonary dysplasia as a predictor factor for motor alteration at 6 months corrected age in premature infants

2010 ◽  
Vol 68 (5) ◽  
pp. 749-754 ◽  
Author(s):  
Priscila Silveira Martins ◽  
Rosane Reis de Mello ◽  
Kátia Silveira da Silva
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Neurological Examination ◽  
Infant Development ◽  
Very Low Birth Weight ◽  
Psychomotor Development ◽  
Predisposing Factor ◽  
Development Index ◽  
Psychomotor Development Index ◽  
Confounding Variables

OBJECTIVE: The study aimed to assess bronchopulmonary dysplasia (BPD) as a predisposing factor for alteration in the psychomotor development index (PDI) in premature infants and verify the incidence of neuromotor alterations at 6 months corrected age. METHOD: This was a prospective cohort study that followed the neuromotor development of 152 very low birth weight premature infants, with psychomotor development index as the outcome. The study used the Bayley Scale of Infant Development at 6 months corrected age, and neurological examination. RESULTS: Incidence of BPD was 13.2% (n=20). Logistic regression analysis showed an association between BPD and altered psychomotor development index (OR 3.98; 95%CI: 1.04-15.1) after adjusting for confounding variables. Neurological examination was altered in 67.1% of the 152 infants. CONCLUSION: Bronchopulmonary dysplasia acted as an independent predisposing factor for alteration in the psychomotor development index in premature infants at 6 months corrected age.

Effect of Zinc Intake on Mental and Motor Development in Infants: A Meta-Analysis

2013 ◽  
Vol 83 (4) ◽  
pp. 203-215 ◽  
Author(s):  
Mariela Nissensohn ◽  
Almudena Sánchez-Villegas ◽  
Daniel Fuentes Lugo ◽  
Patricia Henríquez Sánchez ◽  
Jorge Doreste Alonso ◽  
...  
Keyword(s):  
Motor Development ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Psychomotor Development ◽  
Zinc Intake ◽  
Development Index ◽  
Mental Development Index ◽  
Psychomotor Development Index ◽  
Substantial Heterogeneity

A systematic review and meta-analysis of available randomized controlled trials (RCTs) was conducted to evaluate the effect of zinc (Zn) intake on mental and motor development in infants. Out of 5500 studies identified through electronic searches and reference lists, 5 RCTs were selected after applying the exclusion/inclusion criteria. The influence of Zn intake on mental and motor development was considered in the overall meta-analysis. Other variables were also taken into account as possible effect modifiers: doses of Zn intake, intervention duration, nutritional situation, and risk of bias. Indices of mental and motor development assessed were the Mental Development Index (MDI) and Psychomotor Development Index (PDI). Additionally we carried out a sensitivity analysis. The pooled β was -0.01 (95 %CI -0.02, 0) for MDI and 0 (95 %CI -0.03, 0.02) for PDI, with a substantial heterogeneity in both analyses. When we performed a meta-regression, the effect of Zn supplementation on MDI changed depending on the dose of supplementation. Regarding PDI, there was a differential effect of Zn intake depending on intervention duration, dose of supplementation, nutritional situation, and risk of bias. Zn supplementation showed a negative, weak and significant effect on PDI score in those studies with a length of 4 to 20 weeks (β= -0.05; CI 95 % -0.06 to -0.04). In conclusion, no association was found between Zn intake and mental and motor development in infants. Further standardized research is urgently needed to clarify the role of Zn supplementation upon infant mental and motor development, particularly in Europe.

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