Neuropediatrics 2024; 55(02): 090-096
DOI: 10.1055/a-2236-4003
Original Article

Psychomotor and Cognitive Outcome in Very Preterm Infants in Vorarlberg, Austria, 2007–2019

Fabio Jenni
1   Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
,
Karin Konzett
1   Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
,
Stefanie Gang
1   Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
,
Verena Sparr
1   Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
,
Burkhard Simma
1   Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
› Author Affiliations
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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.

Supplementary Material



Publication History

Received: 14 September 2023

Accepted: 27 December 2023

Accepted Manuscript online:
29 December 2023

Article published online:
12 February 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 World Health Organization. Preterm birth. Accessed January 8, 2023 at: https://www.who.int/news-room/fact-sheets/detail/preterm-birth
  • 2 Konzett K, Kiechl-Kohlendorfer U, Simma B. et al. Frühgeborenennachsorge in Österreich: Etablierung eines nationalen Registers. Monatsschr Kinderheilkd 2022
  • 3 Stephens BE, Vohr BR. Neurodevelopmental outcome of the premature infant. Pediatr Clin North Am 2009; 56 (03) 631-646
  • 4 Delobel-Ayoub M, Kaminski M, Marret S. et al; EPIPAGE Study Group. Behavioral outcome at 3 years of age in very preterm infants: the EPIPAGE study. Pediatrics 2006; 117 (06) 1996-2005
  • 5 Sutton PS, Darmstadt GL. Preterm birth and neurodevelopment: a review of outcomes and recommendations for early identification and cost-effective interventions. J Trop Pediatr 2013; 59 (04) 258-265
  • 6 Apgar V. A proposal for a new method of evaluation of the newborn infant. Originally published in July 1953, volume 32, pages 250-259. Anesth Analg 2015; 120 (05) 1056-1059
  • 7 Hamrick SEG, Sallmon H, Rose AT. et al. Patent ductus arteriosus of the preterm infant. Pediatrics 2020; 146 (05) e20201209
  • 8 Norman J, Shennan A, Jacobsson B, Stock SJ. FIGO Working Group for Preterm Birth. FIGO good practice recommendations on the use of prenatal corticosteroids to improve outcomes and minimize harm in babies born preterm. Int J Gynaecol Obstet 2021; 155 (01) 26-30
  • 9 Dayal S, Hong PL. Premature Rupture of Membranes. . [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. . Available at: https://www.ncbi.nlm.nih.gov/books/NBK532888/. Accessed January 19, 2024
  • 10 Simon LV, Hashmi MF, Bragg BN. APGAR Score. In: StatPearls. [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. . Available at: https://www.ncbi.nlm.nih.gov/books/NBK470569. Accessed January 19, 2024
  • 11 Singh M, Alsaleem M, Gray CP. Neonatal Sepsis. In: StatPearls. [Internet]. Treasure Island, FL: StatPearls Publishing; 2023. . Available at: https://www.ncbi.nlm.nih.gov/books/NBK531478/. Accessed January 19, 2024
  • 12 Bell MJ, Ternberg JL, Feigin RD. et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 1978; 187 (01) 1-7
  • 13 Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978; 92 (04) 529-534
  • 14 Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163 (07) 1723-1729
  • 15 Chiang MF, Quinn GE, Fielder AR. et al. International Classification of Retinopathy of Prematurity, Third Edition. Ophthalmology 2021; 128 (10) e51-e68
  • 16 Duchon J, Barbian ME, Denning PW. Necrotizing enterocolitis. Clin Perinatol 2021; 48 (02) 229-250
  • 17 Siegel LS. Correction for prematurity and its consequences for the assessment of the very low birth weight infant. Child Dev 1983; 54 (05) 1176-1188
  • 18 Fuiko R, Oberleitner-Leeb C, Klebermass-Schrehof K, Berger A, Brandstetter S, Giordano V. The impact of norms on the outcome of children born very-preterm when using the Bayley-III: differences between US and German norms. Neonatology 2019; 116 (01) 29-36
  • 19 Lowe JR, Erickson SJ, Schrader R, Duncan AF. Comparison of the Bayley II Mental Developmental Index and the Bayley III Cognitive Scale: are we measuring the same thing?. Acta Paediatr 2012; 101 (02) e55-e58
  • 20 Moore T, Johnson S, Haider S, Hennessy E, Marlow N. Relationship between test scores using the second and third editions of the Bayley Scales in extremely preterm children. J Pediatr 2012; 160 (04) 553-558
  • 21 Jary S, Whitelaw A, Walløe L, Thoresen M. Comparison of Bayley-2 and Bayley-3 scores at 18 months in term infants following neonatal encephalopathy and therapeutic hypothermia. Dev Med Child Neurol 2013; 55 (11) 1053-1059
  • 22 Yi YG, Sung IY, Yuk JS. Comparison of second and third editions of the Bayley Scales in Children With Suspected Developmental Delay. Ann Rehabil Med 2018; 42 (02) 313-320
  • 23 Konzett K, Riedl D, Stark C, Simma B. Chorioamnionitis and neurodevelopmental outcome in very preterm infants from 2007 to 2017-a population-based study. Acta Paediatr 2021; 110 (04) 1201-1208
  • 24 Kiechl-Kohlendorfer U, Ralser E, Pupp Peglow U, Reiter G, Trawöger R. Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages. Acta Paediatr 2009; 98 (05) 792-796
  • 25 Schlapbach LJ, Adams M, Proietti E. et al; Swiss Neonatal Network & Follow-up Group. Outcome at two years of age in a Swiss national cohort of extremely preterm infants born between 2000 and 2008. BMC Pediatr 2012; 12 (01) 198
  • 26 Serenius F, Källén K, Blennow M. et al; EXPRESS Group. Neurodevelopmental outcome in extremely preterm infants at 2.5 years after active perinatal care in Sweden. JAMA 2013; 309 (17) 1810-1820
  • 27 Struck A, Almaazmi M, Bode H. et al. [Neurodevelopmental outcome of very low birth weight infants born at the Perinatal Centre in Ulm, Germany]. Z Geburtshilfe Neonatol 2013; 217 (02) 65-71
  • 28 Wang L-K, Chen C-Y, Sun F-J, Chen C-P. Neurodevelopmental outcomes at 6, 12, and 24 months of age in preterm infants with very low birth weights in Taiwan. J Formos Med Assoc 2022; 121 (09) 1804-1812
  • 29 Louis D, Oberoi S, Ricci MF. et al. School readiness among children born preterm in Manitoba, Canada. JAMA Pediatr 2022; 176 (10) 1010-1019
  • 30 Kiechl-Kohlendorfer U, Simma B, Urlesberger B. et al; Austrian Preterm Outcome Study Group. Low mortality and short-term morbidity in very preterm infants in Austria 2011-2016. Acta Paediatr 2019; 108 (08) 1419-1426
  • 31 Johnson S, Moore T, Marlow N. Using the Bayley-III to assess neurodevelopmental delay: which cut-off should be used?. Pediatr Res 2014; 75 (05) 670-674
  • 32 Anderson PJ, Burnett A. Assessing developmental delay in early childhood - concerns with the Bayley-III scales. Clin Neuropsychol 2017; 31 (02) 371-381
  • 33 Aylward GP, Zhu J. The Bayley Scales: Clarification for Clinicians and Researcher. NCS Pearson. 2019 . Accessed January 8, 2023 at: https://www.pearsonassessments.com/content/dam/school/global/clinical/us/assets/bayley-4/bayley-4-technical-report.pdf
  • 34 Benavente-Fernández I, Siddiqi A, Miller SP. Socioeconomic status and brain injury in children born preterm: modifying neurodevelopmental outcome. Pediatr Res 2020; 87 (02) 391-398
  • 35 Pierrat V, Marchand-Martin L, Marret S. et al; EPIPAGE-2 writing group. Neurodevelopmental outcomes at age 5 among children born preterm: EPIPAGE-2 cohort study. BMJ 2021; 373 (741) n741
  • 36 Berger A, Kiechl-Kohlendorfer U, Berger J. et al. Erstversorgung von Frühgeborenen an der Grenze der Lebensfähigkeit. Monatsschr Kinderheilkd 2017; 165 (02) 139-147
  • 37 Kirpalani H, Millar D, Lemyre B, Yoder BA, Chiu A, Roberts RS. NIPPV Study Group. A trial comparing noninvasive ventilation strategies in preterm infants. N Engl J Med 2013; 369 (07) 611-620
  • 38 Walsh MC, Yao Q, Gettner P. et al; National Institute of Child Health and Human Development Neonatal Research Network. Impact of a physiologic definition on bronchopulmonary dysplasia rates. Pediatrics 2004; 114 (05) 1305-1311
  • 39 Janz-Robinson EM, Badawi N, Walker K, Bajuk B, Abdel-Latif ME. Neonatal Intensive Care Units Network. Neurodevelopmental outcomes of premature infants treated for patent ductus arteriosus: a population-based cohort study. J Pediatr 2015; 167 (05) 1025-32.e3