Longitudinal Cognitive Assessment in Low-Risk Very Preterm Infants

Griffiths Scales of Child Development 3rd Edition: normalization for the Brazilian population

Introduction

Child development must be carefully evaluated, requiring assessment instruments to assess different areas of development. Griffiths Scales of Child Development 3rd Edition (Griffiths III) is used to assess different areas of development in children. This study normalized Griffiths III for the Brazilian population from 0 to 72 months.

Methods

445 typically developing children from 0 to 72 months, divided into eight groups (from 0 to 6 months; 7 to 12 months; 13 to 18 months; 19 to 24 months; 25 to 36 months; 37 to 48 months; 49 to 60 months; 61 to 72 months) participated. Their tutors answered the anamnesis protocol. Denver II Developmental Screening Test and Griffiths III were applied. Statistical analysis was performed using the Mann-Whitney Test and Spearman's rank correlation coefficient. Normalization followed the criteria of the original scale.

Results

There was a direct and statistically significant correlation between maternal schooling and socioeconomic status; a direct correlation in the performance between the subscales. The normalization table of Griffiths III with the developmental age of children from 0 to 72 months was elaborated through linear progression, calculated using a specific formula.

Discussion

The data collected for the Brazilian population from 0 to 72 months were normalized, following the guidelines and norms of the original Griffiths III.

Neurodevelopmental outcome of low-risk moderate to late preterm infants at 18 months

Background

Of the 15 million preterm births that occur worldwide each year, approximately 80% occur between 32 and 36 + 6 weeks gestational age (GA) and are defined as moderate to late preterm (MLP) infants. This percentage substantiates a need for a better understanding of the neurodevelopmental outcome of this group.

Aim

To describe neurodevelopmental outcome at 18 months in a cohort of healthy low-risk MLP infants admitted to the neonatal unit at birth and to compare the neurodevelopmental outcome to that of a healthy term-born infant group.

Study design and method

This single-centre observational study compared the neurodevelopmental outcome of healthy MLP infants to a group of healthy term control (TC) infants recruited during the same period using the Griffith's III assessment at 18 months.

Results

Seventy-five MLP infants and 92 TC infants were included. MLP infants scored significantly lower in the subscales: Eye-hand coordination (C), Personal, Social and Emotional Development (D), Gross Motor Development (E) and General Developmental (GD) (p < 0.001 for each) and Foundations of Learning (A), (p = 0.004) in comparison to the TC infant group with Cohen's d effect sizes ranging from 0.460 to 0.665. There was no statistically significant difference in mean scores achieved in subscale B: Language and Communication between groups (p = 0.107).

Conclusion

MLP infants are at risk of suboptimal neurodevelopmental outcomes. Greater surveillance of the neurodevelopmental trajectory of this group of at-risk preterm infants is required.

Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors

OBJECTIVE

To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors.

METHODS

Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months.

RESULTS

Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms.

CONCLUSIONS

These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.