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Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network.

Publication ,  Journal Article
Adams-Chapman, I; Heyne, RJ; DeMauro, SB; Duncan, AF; Hintz, SR; Pappas, A; Vohr, BR; McDonald, SA; Das, A; Newman, JE; Higgins, RD ...
Published in: Pediatrics
May 2018

OBJECTIVES: Evaluate the spectrum of neurodevelopmental outcome in a contemporary cohort of extremely preterm infants. We hypothesize that the rate of severe neurodevelopmental impairment (NDI) decreases over time. METHODS: Retrospective analysis of neurodevelopmental outcome of preterm infants ≤27 weeks' gestational age (GA) from a Neonatal Research Network center that completed neurodevelopmental follow-up assessments between April 1, 2011, and January 1, 2015. The Bayley Scales of Infant Development-III (BSID III) and a standardized neurosensory examination were performed between 18 and 26 months' adjusted age. Outcome measures were neurologic examination diagnoses, BSID III cognitive and motor scores, sensory impairment, and the composite outcome of NDI, based on the BSID III cognitive score (analyzed by using a cutoff of <85 or <70), BSID III motor score of <70, moderate or severe cerebral palsy (CP), bilateral blindness, and hearing impairment. RESULTS: Two thousand one hundred and thirteen infants with a mean GA of 25.0 ± 1.0 weeks and mean birth weight of 760 ± 154 g were evaluated. The 11% lost to follow-up were less likely to have private insurance, late-onset sepsis, or severe intraventricular hemorrhage. Neurologic examination results were normal in 59%, suspect abnormal in 19%, and definitely abnormal in 22%. Severe CP decreased 43% whereas mild CP increased 13% during the study. The rate of moderate to severe NDI decreased from 21% to 16% when using the BSID III cognitive cutoff of <70 (P = .07) or from 34% to 31% when using the BSID III cognitive cutoff of <85 (P = .67). CONCLUSIONS: Extremely preterm children are at risk for NDI. Over time, the rate of moderate to severe NDI did not differ, but the rates of severe CP decreased, and mild CP increased.

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Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

May 2018

Volume

141

Issue

5

Location

United States

Related Subject Headings

  • Socioeconomic Factors
  • Severity of Illness Index
  • Sensation Disorders
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Neurologic Examination
  • Motor Disorders
  • Male
  • Infant, Newborn
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Adams-Chapman, I., Heyne, R. J., DeMauro, S. B., Duncan, A. F., Hintz, S. R., Pappas, A., … Follow-Up Study of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, . (2018). Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network. Pediatrics, 141(5). https://doi.org/10.1542/peds.2017-3091
Adams-Chapman, Ira, Roy J. Heyne, Sara B. DeMauro, Andrea F. Duncan, Susan R. Hintz, Athina Pappas, Betty R. Vohr, et al. “Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network.Pediatrics 141, no. 5 (May 2018). https://doi.org/10.1542/peds.2017-3091.
Adams-Chapman I, Heyne RJ, DeMauro SB, Duncan AF, Hintz SR, Pappas A, et al. Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network. Pediatrics. 2018 May;141(5).
Adams-Chapman, Ira, et al. “Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network.Pediatrics, vol. 141, no. 5, May 2018. Pubmed, doi:10.1542/peds.2017-3091.
Adams-Chapman I, Heyne RJ, DeMauro SB, Duncan AF, Hintz SR, Pappas A, Vohr BR, McDonald SA, Das A, Newman JE, Higgins RD, Follow-Up Study of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network. Pediatrics. 2018 May;141(5).

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

May 2018

Volume

141

Issue

5

Location

United States

Related Subject Headings

  • Socioeconomic Factors
  • Severity of Illness Index
  • Sensation Disorders
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Neurologic Examination
  • Motor Disorders
  • Male
  • Infant, Newborn