Pre-eclampsia Complicated With Maternal Renal Dysfunction Is Associated With Poor Neurological Development at 3 Years Old in Children Born Before 34 Weeks of Gestation

Objective: The purpose of this study was to investigate perinatal factors associated with a poor neurodevelopmental outcome in preterm infants.Methods: A retrospective study was conducted by searching our clinical database between January 2006 and December 2016. A total of 165 singleton children who were born between 23 and 33 weeks of gestation were included. We defined poor neurological development outcomes as follows: cerebral palsy; intellectual disability; developmental disorder including autism and attention-deficit/hyperactivity disorder; low score (<85 points) on Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III); or low score of Kyoto Scale of Psychological Development corrected at 3 years old. We diagnosed maternal renal dysfunction according to the Clinical Practice Guideline for chronic kidney disease 2018 and the Best Practice Guide 2015 for Care and Treatment of Hypertension in Pregnancy.Results: The rate of poor neurological development was 25/165 (15.2%): cerebral palsy (n = 1), intellectual disability (n = 1), developmental disorder (n = 2), low score of Bayley-III (n = 20), and low score of Kyoto Scale of Psychological Development (n = 1). Preeclampsia complicated with maternal renal dysfunction (P = 0.045) and delivery at <30 weeks of gestation (P = 0.007) were independent risk factors for poor neurological development.Conclusions: In addition to previous risk factors such as delivery at <30 weeks of gestation, preeclampsia complicated with renal dysfunction was also associated with poor neurodevelopmental outcomes corrected at 3 years old.

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

Diseases of the Esophagus ◽

10.1093/dote/doz047.81 ◽

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.

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37 Growth and neurodevelopment in early childhood of preterm infants with complex congenital heart defects following open cardiac surgery

Paediatrics & Child Health ◽

10.1093/pch/pxaa068.036 ◽

2020 ◽

Vol 25 (Supplement_2) ◽

pp. e14-e15

Author(s):

Po-Yin Cheung ◽

Morteza Hajihosseini ◽

Irina Dinu ◽

Heather Switzer ◽

Charlene M T Robertson

Keyword(s):

Early Childhood ◽

Hearing Loss ◽

Cardiac Surgery ◽

Cerebral Palsy ◽

Preterm Infants ◽

Congenital Heart Defects ◽

Congenital Heart ◽

Heart Defects ◽

Neurodevelopmental Outcome ◽

Neurodevelopmental Outcomes

Abstract Background Compared with those born at term gestation, infants with complex congenital heart defects (CCHD) who were delivered before 37 weeks of gestational age and received neonatal open cardiac surgery (OHS) have poorer neurodevelopmental outcomes in early childhood. Specific details related to the neurodevelopmental outcome of these infants remain unpublished. Objectives To describe the growth, disability, functional, and neurodevelopmental outcome in early childhood of preterm infants (born at <37+0 weeks gestation) with CCHD and neonatal OHS. Design/Methods We studied all infants with CCHD who received OHS within 6 weeks of corrected age between 1996 and 2016. In the Western Canadian Complex Pediatric Therapies Follow-up Program, comprehensive neurodevelopmental assessments at a corrected age of 18-24 months were done by multidisciplinary teams at the original referral sites. In addition to demographic and clinical data, standardized age-appropriate outcome measures included physical growth with calculated Z-scores, disabilities including cerebral palsy, visual impairment, sensorineural hearing loss; adaptive function (Adaptive Behavioural Assessment System-II); and cognitive, language, and motor skills (Bayley Scales of Infant and Toddler Development-III). Results From 1996 to 2016, 115 preterm infants (34±2 weeks gestation, 2339±637g, 64% males) with CCHD had OHS with 11(10%) deaths before first discharge and 21 (18%) by 2 years. Prior to the first surgery, 7 (6%) neonates had cerebral injuries. Overall, 7 had necrotizing enterocolitis; none had retinopathy of prematurity. All 94 surviving infants received comprehensive evaluation at 2 years corrected age; Eighteen (19%) had congenital syndromes who had worse functional and neurodevelopmental outcomes compared to those (n=76) without syndromal abnormalities (SA) (Table). Conclusion For preterm neonates with CCHD and early OHS, the mortality was significant, but the short-term neonatal morbidity was not increased. Compared with published preterm outcomes, the early outcome suggests more cerebral palsy but not sensorineural hearing loss, and greater neurodevelopmental delay. This information is important for management care of the infants, parental counselling and the decision-making process.

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What a psychiatrist needs to know about copy number variants

BJPsych Advances ◽

10.1192/apt.bp.113.012039 ◽

2015 ◽

Vol 21 (3) ◽

pp. 157-163 ◽

Cited By ~ 7

Author(s):

George Kirov ◽

Elliott Rees ◽

James Walters

Keyword(s):

Risk Factors ◽

Intellectual Disability ◽

Neurodevelopmental Disorders ◽

Early Onset ◽

Copy Number ◽

Structural Changes ◽

Developmental Disorder ◽

Copy Number Variants ◽

Clinical Genetics

SummaryCopy number variants (CNVs) are structural changes in chromosomes that result in deletions, duplications, inversions or translocations of large DNA segments. Eleven confirmed CNV loci have been identified as rare but important risk factors in schizophrenia. These CNVs are also associated with other neurodevelopmental disorders and medical/physical comorbidities. Although the penetrance of the CNVs for schizophrenia (the chance that CNV carriers will develop the disorder) is modest, the penetrance of CNVs for any early-onset developmental disorder (e.g. intellectual disability or autism) is much higher. Testing for CNVs is now affordable and being used in clinical genetics and neurodevelopmental disorders clinics. It is possible that testing will be expanded to psychiatric clinics. This article provides a clinically relevant overview of recent CNV findings in schizophrenia and related disorders.

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Influence of Maternal Preeclampsia on Neurodevelopmental Outcomes of Preterm Infants

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2018.737 ◽

2018 ◽

Vol 24 (2) ◽

pp. 99

Author(s):

Halil Degirmencioglu ◽

Birgul Say ◽

Zeynep Ustunyurt ◽

Serife Suna Oguz

Keyword(s):

Cerebral Palsy ◽

Preterm Infants ◽

Gestational Age ◽

Infant Development ◽

Neurodevelopmental Outcome ◽

Control Group ◽

Neurodevelopmental Outcomes ◽

Term Outcome ◽

Long Term Outcome ◽

The Mean

Objective: The aim of this study was to determine the neurodevelopmental outcome of preterm infants born to mothers with preeclampsia and to compare them with preterm controls.Study design: This was a retrospective, observational study in a large, tertiary, neonatal intensive care unit. Neurodevelopmental evaluations using Bayley Scales of Infant Development II were performed in 226 two-year-old infants with birth weight ≤1500 g and gestational age ≤32 weeks who were born to mothers with preeclampsia and in 493 infants who were born after normotensive pregnancies, matched for gestational age and gender.Results: The mean gestational ages of the infants in the preeclampsia and control groups were 29.9±2.3 weeks and 28.7±4.1 weeks, respectively (p<0.001). A total of 372 infants with a mean age of 19.2±3.2 months were assessed for long-term outcome. The mean mental developmental index score was significantly higher, and the percentage of infants with cerebral palsy was significantly lower, in the preeclampsia group compared with the control group (p=0.03 and p=0.02, respectively). However, no overall significant differences in neurodevelopmental impairment rates were found between the two groups (p=0.08).Conclusion: Maternal preeclampsia seems to be a protector factor for the development of cerebral palsy in preterm infants.

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Delayed Achievement of Oral Feedings Is Associated with Adverse Neurodevelopmental Outcomes at 18 to 26 Months Follow-up in Preterm Infants

American Journal of Perinatology ◽

10.1055/s-0039-1681059 ◽

2019 ◽

Vol 37 (05) ◽

pp. 483-490 ◽

Cited By ~ 1

Author(s):

Shabnam Lainwala ◽

Natalia Kosyakova ◽

Kimberly Power ◽

Naveed Hussain ◽

James E. Moore ◽

...

Keyword(s):

Cerebral Palsy ◽

Retrospective Study ◽

Preterm Infants ◽

Neurodevelopmental Outcome ◽

Oral Intake ◽

Neurodevelopmental Outcomes ◽

Motor Delay ◽

Postmenstrual Age ◽

Multivariable Analyses

Abstract Objective This study aimed to compare neurodevelopmental outcomes in preterm infants at 18 to 26 months corrected age (CA) who did versus did not achieve full oral feedings at 40 weeks postmenstrual age (PMA). Study Design This retrospective study included infants born between 2010 and 2015 with gestational age <32 weeks and followed between 18 and 26 months CA. Achievement of full oral feedings was defined as oral intake >130 mL/kg/d for >72 hours by 40 weeks PMA. Incidence of cognitive, language, or motor delay, or cerebral palsy at 18 to 26 months CA was compared in multivariable analyses for infants in the two feeding groups. Results Of 372 included infants, those achieving full oral feedings had lower incidence of any adverse neurodevelopmental outcome (p < 0.001) compared with those who did not achieve full oral feedings. In multivariable analyses, achievement of full oral feedings by 40 weeks PMA was associated with decreased odds of cognitive, language, and motor delays, cerebral palsy, and any adverse neurodevelopmental outcome at follow-up. Conclusion Achievement of full oral feedings by 40 weeks PMA was associated with better adjusted neurodevelopmental outcomes at 18 to 26 months CA. Inability to fully feed orally at 40 weeks PMA may be a simple, clinically useful marker for risk of adverse neurodevelopmental outcomes.

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Neurodevelopmental outcomes following preterm birth and the association with postmenstrual age at discharge

American Journal of Perinatology ◽

10.1055/a-1733-2690 ◽

2022 ◽

Author(s):

Polly Kellner ◽

Jenny Kwon ◽

Joan Smith ◽

Roberta G Pineda

Keyword(s):

Risk Factors ◽

Preterm Infants ◽

Ductus Arteriosus ◽

Neurodevelopmental Outcome ◽

Cognitive Outcome ◽

Composite Score ◽

Neurodevelopmental Outcomes ◽

Medical Risk ◽

Medical Risk Factors ◽

Postmenstrual Age

Objective: To 1) define the prevalence of motor, cognitive, and language delays in preterm infants born < 32 weeks estimated gestational age (EGA) and 2) identify the relationship between the timing of discharge from the NICU and neurodevelopmental outcome in early childhood. Study Design: This retrospective study of 176 preterm infants born < 32 weeks EGA and hospitalized in a level IV NICU captured medical factors, including timing of discharge, from the NICU stay. Standardized developmental testing at 1-2 years corrected age was conducted in the newborn follow-up clinic. Results: At 1-2 years corrected age, the sample had an average cognitive composite score of 91.5 ± 17.4, language composite score of 84.5 ± 17.3, and motor composite score of 88.9 ± 18.4. Lower EGA at birth, necrotizing enterocolitis, patent ductus arteriosus, and oxygen requirement for > 28 days were independently associated with higher postmenstrual age (PMA) at NICU discharge. After controlling for known risk factors, higher PMA at discharge was associated with poorer cognitive outcome [p < 0.001, (-0.16, -0.07), β = -0.35], poorer language outcome [p = 0.049 (-0.10, 0.00), β = -0.15] and poorer motor outcome [p < 0.001, (-0.14, -0.05), β = -0.30]. Conclusion: Poorer cognitive, language, and motor outcomes were associated with longer hospitalization, even after controlling for medical risk factors known to be associated with poorer outcome. This provides further evidence for the potential role of the environment that may be impacting the developmental outcomes of infants hospitalized in the NICU.

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Neuroprem 2: An Italian Study of Neurodevelopmental Outcomes of Very Low Birth Weight Infants

Frontiers in Pediatrics ◽

10.3389/fped.2021.697100 ◽

2021 ◽

Vol 9 ◽

Author(s):

Licia Lugli ◽

Luca Bedetti ◽

Isotta Guidotti ◽

Marisa Pugliese ◽

Odoardo Picciolini ◽

...

Keyword(s):

Risk Factors ◽

Cerebral Palsy ◽

Birth Weight ◽

Gestational Age ◽

Functional Disability ◽

Very Low Birth Weight ◽

Neurodevelopmental Outcomes ◽

Vlbw Infants ◽

Neurodevelopmental Disabilities

Background: Despite the increased survival of preterm newborns worldwide, the risk of neurodevelopmental disabilities remains high. Analyzing the outcomes of the preterm population can identify risk factors and enable specific early interventions.Aims: Neuroprem is a prospective cohort study of very low birth weight (VLBW) infants that aims to evaluate the neurodevelopmental outcomes and risk factors for severe functional disability at 2 years of corrected age.Methods: Nine Italian neonatal intensive care units participated in the network. The Griffiths Mental Developmental Scales (GMDS-R) or the Bayley Scales of Infant and Toddler Development (BSDI III) and a neuro-functional evaluation (according to the International Classification of Disability and Health and Neuro-Functional Assessment, or NFA ICF-CY) were administered to VLBW infants at 24 months of corrected age. The primary outcome measure was severe functional disability, defined as cerebral palsy, bilateral blindness, deafness, an NFA ICF-CY of >2, a BSDI III cognitive composite score of <2 SD, or a GMDS-R global quotient score of <2 SD. Perinatal risk factors for severe functional disability were assessed through multivariate logistic regression analysis.Results: Among 502 VLBW survivors who completed the 24-month follow-up, 48 (9.6%) presented severe functional disability, of whom 27 had cerebral palsy (5.4%). Rates of severe functional disability and cerebral palsy were higher in neonates with a lower gestational age (p < 0.001). Overall, 147 infants (29.3%) were referred to neuromotor intervention. In the multivariate regression model, gestational age at birth OR 0.79; 95% CI 0.67–0.90; p = 0.001) and periventricular-intraventricular hemorrhage (OR 2.51; 95% CI 1.19–5.26; p = 0.015) were significantly associated with severe functional disability.Conclusion: Neuroprem 2 provides updated information on the neurodevelopmental outcomes of VLBW infants in a large Italian cohort. The overall rate of neurodevelopmental disabilities was quite lower than reported in the previous literature. These data indicate the need for structured follow-up programs from a national neonatal network perspective.

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