Neurodevelopmental impairment among extremely preterm infants in the neonatal research network

Follow-Up Study of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article numbere20173091
JournalPediatrics
Volume141
Issue number5
DOIs
StatePublished - May 1 2018
Externally publishedYes

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Extremely Premature Infants
Cerebral Palsy
Research
Neurologic Examination
Gestational Age
Lost to Follow-Up
Blindness
Child Development
Insurance
Hearing Loss
Birth Weight
Premature Infants
Sepsis
Outcome Assessment (Health Care)
Hemorrhage

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

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), [e20173091]. https://doi.org/10.1542/peds.2017-3091

Neurodevelopmental impairment among extremely preterm infants in the neonatal research network. / Follow-Up Study of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.

In: Pediatrics, Vol. 141, No. 5, e20173091, 01.05.2018.

Research output: Contribution to journalArticle

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, vol. 141, no. 5, e20173091. https://doi.org/10.1542/peds.2017-3091
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 1;141(5). e20173091. https://doi.org/10.1542/peds.2017-3091
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. In: Pediatrics. 2018 ; Vol. 141, No. 5.
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abstract = "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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T1 - Neurodevelopmental impairment among extremely preterm infants in the neonatal research network

AU - Follow-Up Study of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

AU - Adams-Chapman, Ira

AU - Heyne, Roy J.

AU - DeMauro, Sara B.

AU - Duncan, Andrea F.

AU - Hintz, Susan R.

AU - Pappas, Athina

AU - Vohr, Betty R.

AU - McDonald, Scott A.

AU - Das, Abhik

AU - Newman, Jamie E.

AU - Higgins, Rosemary D.

AU - Polin, Richard A.

AU - Laptook, Abbot R.

AU - Keszler, Martin

AU - Hensman, Angelita M.

AU - Vieira, Elisa

AU - Burke, Robert T.

AU - Stephens, Bonnie E.

AU - Alksninis, Barbara

AU - Bishop, Carmena

AU - Keszler, Mary L.

AU - Leach, Teresa M.

AU - Watson, Victoria E.

AU - Walsh, Michele C.

AU - Fanaroff, Avroy A.

AU - Newman, Nancy S.

AU - Wilson-Costello, Deanne E.

AU - Siner, Bonnie S.

AU - Friedman, Harriet G.

AU - Truog, William E.

AU - Pallotto, Eugenia K.

AU - Kilbride, Howard W.

AU - Gauldin, Cheri

AU - Holmes, Anne

AU - Johnson, Kathy

AU - Knutson, Allison

AU - Schibler, Kurt

AU - Kallapur, Suhas G.

AU - Yolton, Kimberly

AU - Alexander, Barbara

AU - Fischer, Estelle E.

AU - Gratton, Teresa L.

AU - Grisby, Cathy

AU - Jennings, Jennifer

AU - Kirker, Kristin

AU - Jackson, Lenora D.

AU - Wuertz, Sandra

AU - Cotton, C. Michael

AU - Goldberg, Ronald N.

AU - Lakshminrusimha, Satyanarayana

PY - 2018/5/1

Y1 - 2018/5/1

N2 - 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.

AB - 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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