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Jenni F, Konzett K, Gang S, Sparr V, Simma B. Psychomotor and Cognitive Outcome in Very Preterm Infants in Vorarlberg, Austria, 2007-2019. Neuropediatrics 2024; 55:90-96. [PMID: 38158208 DOI: 10.1055/a-2236-4003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
AIM The aim of this study was to analyze neurodevelopmental outcome of very and extremely preterm infants in Vorarlberg, Austria, accessed with neurodevelopmental testing, at the corrected age of 24 months. This article also compared these results with (inter)national data and analyzed the impact of perinatal parameters. METHODS Population-based, retrospective multicenter study with data on very and extremely preterm infants born in Vorarlberg from 2007 to 2019 assessed with Bayley Scales of Infant Development (BSID-II/Bayley-III). RESULTS Included were 264 infants with a mean age of 29.0 (± 2.1) weeks of gestational age and a mean birth weight of 1177 (± 328.26) g; 172 infants underwent a BSID-II, 92 a Bayley-III assessment. The psychomotor developmental index (PDI) and mental developmental index (MDI) showed mean scores of 99.6 (± 14.4) and 91 (± 20.4), respectively. Adverse outcomes (scores <70) were assessed in 4.2% for PDI and 15.5% for MDI. In the extremely preterm group (n = 79), results for mean PDI were 100.1 (± 16.8) and for mean MDI 88.4 (± 22.4). Accordingly, adverse outcomes were assessed in 5.1% for PDI and in 20.3% for MDI. In addition to bronchopulmonary dysplasia and intraventricular hemorrhage Grade 3-4, head circumference at birth and patent ductus arteriosus were also identified as risk factors for poor outcome. CONCLUSION This study showed a remarkably good neurodevelopmental outcome in preterm infants with low rates of adverse outcome, similar to (inter)national reports, especially in the group of extremely preterm infants. Research is needed to explore the role of social factors and infants' environment, especially cognitive outcome and language skills.
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Affiliation(s)
- Fabio Jenni
- Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
| | - Karin Konzett
- Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
| | - Stefanie Gang
- Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
| | - Verena Sparr
- Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
| | - Burkhard Simma
- Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
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Louis D, Akil H, Oberoi S, Sirski M, Alvaro R, Seshia M, Moddemann D, Lix LM, Ruth C, Garland A. Grade 7 school performance of children born preterm: a retrospective Canadian Cohort study. J Perinatol 2024:10.1038/s41372-024-01911-9. [PMID: 38438788 DOI: 10.1038/s41372-024-01911-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/31/2024] [Accepted: 02/13/2024] [Indexed: 03/06/2024]
Abstract
IMPORTANCE Data on the middle school outcomes of preterm children are limited and have methodologic issues. OBJECTIVE To study the association between preterm birth and grade 7 school performance. METHODS A retrospective population-based cohort study of children born in Manitoba, Canada between 1994 and 2006 using their grade 7 school performance data. A secondary sibling cohort was created comprising children born preterm and their full-term siblings. Primary exposure was preterm birth categorized as <28, 28-33 and 34-36 weeks gestation. The two co-primary grade 7 outcome measures were: not meeting the mathematics competencies, and not meeting the student engagement competencies. Multivariable logistic regression models tested the association between preterm birth and both co-primary outcomes; adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. RESULTS 7653 preterm (gestational age median [IQR]: 35 weeks [34,36]) and 110,313 term (40 [39,40]) were included. 43% of < 28 weeks, 18% of 28-33 weeks and 17% of 34-36 weeks had the mathematics co-primary outcome compared to 13% of term children. The corresponding % for the student engagement outcome were 42%, 24%, 24% and 24% respectively. Preterm birth was associated with the mathematics (<28 weeks: 5.48, 3.89-7.70; 28-33 weeks: 1.47, 1.27-1.70; 34-36 weeks: 1.26, 1.16-1.35) and student engagement outcomes (<28 weeks: 2.49, 1.76-3.51; 28-33 weeks: 1.21, 1.06-1.39; 34-36 weeks: 1.09, 1.01-1.16). However, there was no difference in outcomes among the sibling cohort. CONCLUSIONS AND RELEVANCE Children born preterm had lower grade 7 performance compared to children born term in this population-based cohort. Screening and supports for them in their middle school years are warranted.
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Affiliation(s)
- Deepak Louis
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada.
| | - Hammam Akil
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Sapna Oberoi
- Division of Pediatric Hematology-Oncology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Monica Sirski
- Data analyst, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Ruben Alvaro
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Mary Seshia
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Diane Moddemann
- Neonatal Follow-up Program, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Chelsea Ruth
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Allan Garland
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
- Department of Medicine, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Barile JG, Han K, Milanaik R. The Prematurity Paradox: Reevaluating the Kindergarten Readiness of Former Preterm Infants. Pediatrics 2024; 153:e2023063801. [PMID: 38186291 DOI: 10.1542/peds.2023-063801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- Joseph G Barile
- Cohen Children's Medical Center, Northwell Health Affiliate, New Hyde Park, New York
| | - Kyle Han
- Cohen Children's Medical Center, Northwell Health Affiliate, New Hyde Park, New York
| | - Ruth Milanaik
- Cohen Children's Medical Center, Northwell Health Affiliate, New Hyde Park, New York
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Christensen R, Chau V, Synnes A, Guo T, Grunau RE, Miller SP. Preterm Neurodevelopmental Trajectories from 18 Months to 4.5 Years. J Pediatr 2023; 258:113401. [PMID: 37019331 DOI: 10.1016/j.jpeds.2023.113401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To assess the longitudinal trajectory of cognitive, language, and motor outcomes from 18 months to 4.5 years of age in children born very preterm. STUDY DESIGN This was a prospective cohort study of 163 infants born very preterm (born 24-32 weeks of gestation) followed longitudinally and assessed with neurodevelopmental scales and magnetic resonance imaging of the brain. Outcomes at 18 months and 3 years were assessed with the Bayley Scales of Infant and Toddler Development, 3rd Edition, and at 4.5 years with the Wechsler Preschool and Primary Scale of Intelligence-III and the Movement Assessment Battery for Children. Cognitive, language, and motor outcomes were categorized as below-average, average, and above-average, and compared across time. Clinical data were analyzed using ANOVA, χ2 tests, and linear regression. RESULTS Cognitive and language trajectories were stable from 18 months to 4.5 years for all outcome groups. Motor impairment increased over time, with a greater proportion of children having motor deficits at 4.5 years. Children with below-average cognitive and language outcomes at 4.5 years had more clinical risk factors, greater white matter injury, and lower maternal education. Children with severe motor impairment at 4.5 years were born earlier, had more clinical risk factors, and demonstrated greater white matter injury. CONCLUSIONS Children born preterm have stable cognitive and language trajectories, while motor impairment increased at 4.5 years. These results highlight the importance of continued developmental surveillance for children born preterm into preschool age.
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Affiliation(s)
- Rhandi Christensen
- Division of Neurology, Department of Pediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Vann Chau
- Division of Neurology, Department of Pediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anne Synnes
- Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Ting Guo
- Division of Neurology, Department of Pediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Steven P Miller
- Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
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Louis D, Ruth C, Garland A. Factors Moderating the Association Between Preterm Birth and Low School Readiness-Reply. JAMA Pediatr 2023; 177:102. [PMID: 36409507 DOI: 10.1001/jamapediatrics.2022.4673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Deepak Louis
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Chelsea Ruth
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allan Garland
- Department of Medicine, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Han Y, Zhou Z. Factors Moderating the Association Between Preterm Birth and Low School Readiness. JAMA Pediatr 2023; 177:101-102. [PMID: 36409513 DOI: 10.1001/jamapediatrics.2022.4670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yanping Han
- Department of Endocrinology, Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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