Neuropsychological Development and New Criteria for Extrauterine Growth Restriction in Very Low-Birth-Weight Children
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Description of the Growth of 87 Cases Studied
3.2. Description of Results of Neuropsychological Tests
3.3. Relationship between Growth and Neurological Clinical Development and Neuropsychological Tests
4. Discussion
4.1. Growth
4.2. Neuropsychological Test
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Studied Cases (n = 87) | Survivors Lost (n = 60) | Statistical Significance | |
---|---|---|---|
Weight (g): median (IQR) | 1220 (430) | 1163 (413) | 0.682 # |
Gestational age (weeks) mean (CI 95%) | 29.6 (29.0–30.2) | 29.8 (29.0–30.6) | 0.774 & |
Sex: male/female (n) | 51/36 | 31/29 | 0.404 @ |
Multiple birth (n) | 30 | 15 | 0.220 @ |
Type of delivery: Vaginal/Caesarean (n) | 27/60 | 23/37 | 0.359 @ |
Apgar test (n) | |||
1 min: 0–3/4–6/>6 | 9/16/62 | 4/10/46 | 0.689 @ |
5 min: 0–3/4–6/>6 | 1/5/81 | 2/0/58 | 0.115 @ |
Neonatal resuscitation (n) | |||
Oxygen | 74 | 49 | 0.585 @ |
Ambu with mask | 57 | 32 | 0.137 @ |
CPAP nasal | 26 | 18 | 0.737 @ |
Intubation | 35 | 18 | 0.204 @ |
Heart massage and/or Drugs | 7 | 2 | 0.188 @ |
Respiratory support: | |||
Oxygen | 78 | 51 | 0.397 @ |
Non-invasive ventilation (IMVn) | 46 | 33 | 0.799 @ |
Conventional ventilation | 47 | 37 | 0.357 @ |
High frequency ventilation | 2 | 2 | 0.705 @ |
Diagnoses: | |||
Hyaline membrane disease | 43 | 31 | 0.789 @ |
Patent ductus arteriosus | 21 | 16 | 0.728 @ |
Necrotizing enterocolitis | 4 | 1 | 0.335 @ |
Early sepsis | 1 | 2 | 0.357 @ |
Transfusable anaemia | 35 | 23 | 0.678 @ |
Late sepsis | 23 | 18 | 0.636 @ |
Intracranial haemorrhage | 21 | ||
I or II | 2 | 15 | 0.562 @ |
III or IV | 4 | ||
Periventricular leukomalacia | 9 | 6 | 0.774 @ |
Retinopathy of prematurity | |||
I | 13 | 8 | 0.985 @ |
II or III | 15 | 9 | |
Fundus not performed | 4 | 3 | |
Neurological development: | |||
- Neurological disorders of any kind | 19 | 14 | 0.831 @ |
- Major neurological disorders | 7 | 8 | 0.297 @ |
- Congenital alterations not related | 2 | 2 | 0.704 @ |
- Cerebral palsy | 5 | 5 | 0.540 @ |
- Severe developmental disorders | 3 | 2 | 0.969 @ |
- Language disorders | 12 | 4 | 0.172 @ |
- Behavioural disorders and/or attention deficit hyperactivity disorder | 3 | 2 | 0.969 @ |
Weight (g) | Length (cm) | Head Circumference (cm) | |
---|---|---|---|
Birth | |||
Mean (CI 95%) | 1153 (1101–1204) | 37.8 (37.1–38.5) | 26.2 (25.7–26.7) |
Median (IQR) | 1220 (430) | 38.0 (5) | 27.0 (4) |
Neonatal discharge | |||
Mean (CI 95%) | 2325 (2277–2372) | 45.4 (45.0–45.8) | 33.2 (32.9–33.5) |
Median (IQR) | 2260 (225) | 45.0 (2.5) | 33.0 (1.5) |
2 years | |||
Mean (CI 95%) | 11403 (11030–11775) | 86.0 (84.9–87.1) | 48.4 (48.0–49.8) |
Median (IQR) | 11425 (2100) | 86.0 (6.5) | 48.5 (2.0) |
Weight | Length | Head Circumference | ||
---|---|---|---|---|
Birth | IUGR | |||
Fenton less than P10 | 33 (37.9%) | 23 (26.4%) | 29 (33.3%) | |
IGW-21 less tan P10 | 34 (39.1%) | 28 (32.2%) | 34 (39.1%) | |
Kappa concordance | 0.879 | 0.807 | 0.826 | |
Neonatal discharge | Static EUGR (cross-sectional) | |||
Fenton less than P10 | 78 (89.7%) | 68 (78.2%) | 25 (28.7%) | |
IGW-21 less than P10 | 66 (75.9%) | 63 (72.4%) | 28 (32.2%) | |
Kappa concordance | 0.532 | 0.785 | 0.81 | |
Fenton less than −2 SD | 50 (57.5%) | 41 (47.1%) | 11 (12.6%) | |
IGW-21 less than −2 SD | 41 (47.1%) | 42 (48.3%) | 15 (17.2%) | |
Kappa concordance | 0.795 | 0.839 | 0.82 | |
True EUGR | ||||
For Fenton | 46 (52.8%) | 45 (51.7%) | 9 (10.3%) | |
For IGW-21 | 32 (36.8%) | 38 (43.6%) | 10 (11.5%) | |
Kappa concordance | 0.683 | 0.748 | 0.705 | |
Dynamic EUGR (logitudinal) | ||||
More than -1 SD Fenton | 54 (62.1%) | 56 (64.4%) | 17 (19.5%) | |
More than -1 SD IGW-21 | 41 (47.1%) | 45 (48.3%) | 17 (19.5%) | |
Kappa concordance | 0.705 | 0.605 | 0.781 | |
More than −2 SD Fenton | 23 (26.4%) | 26 (29.9%) | 8 (9.2%) | |
More than −2 SD IGW-21 | 19 (21.8%) | 26 (29.9%) | 8 (9.2%) | |
Kappa concordance | 0.875 | 0.89 | 0.862 | |
2 years | OMS less than −2 SD | 12 (15.2%) | 7 (8.9%) | 4 (5.1%) |
Diagnosed Clinical Neurological Disorders (n = 19) | Not Diagnosed Clinical Neurological Disorders (N = 68) | Est Sig # (p) | |
---|---|---|---|
RIST (median (IQR)) | 89 (42) | 91 (18) | 0.426 |
Inhibition (median (IQR)) | 7 (5) | 10 (4) | 0.002 |
Memory for names (median (IQR)) | 9 (7) | 10 (4) | 0.492 |
Memory for designs (median (IQR)) | 10 (3) | 10 (4) | 0.630 |
Route finding (median (IQR)) | 1 (1) | 3 (4) | 0.010 |
Yes | No | Est Sig | |
---|---|---|---|
IUGR weight Fenton < P10 | 84 (20) | 95 (25) | 0.037 |
IUGR length Fenton < P10 | 84 (22) | 93 (25) | 0.027 |
IUGR length IGW-21 < P10 | 84 (24) | 93 (25) | 0.025 |
IUGR HC Fenton < P10 | 84 (18) | 93 (25) | 0.006 |
IUGR HC IGW-21 < P10 | 84 (18) | 93 (25) | 0.047 |
Static EUGR length Fenton < −2 SD | 84 (20) | 93 (28) | 0.03 |
Static EUGR length IGW-21 < −2 SD | 84 (19) | 95 (28) | 0.01 |
Static EUGR HC Fenton < P10 | 83 (25) | 93 (23) | 0.018 |
Static EUGR HC IGW-21 < P10 | 85 (23) | 92 (23) | 0.001 |
Two years HC OMS < −2 SD | 70 (28) | 92 (21) | 0.025 |
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Alcántara, L.; Fernández-Baizán, C.; González-García, L.; García-López, E.; González-López, C.; Arias, J.L.; Méndez, M.; Sánchez, G.S. Neuropsychological Development and New Criteria for Extrauterine Growth Restriction in Very Low-Birth-Weight Children. Children 2021, 8, 955. https://0-doi-org.brum.beds.ac.uk/10.3390/children8110955
Alcántara L, Fernández-Baizán C, González-García L, García-López E, González-López C, Arias JL, Méndez M, Sánchez GS. Neuropsychological Development and New Criteria for Extrauterine Growth Restriction in Very Low-Birth-Weight Children. Children. 2021; 8(11):955. https://0-doi-org.brum.beds.ac.uk/10.3390/children8110955
Chicago/Turabian StyleAlcántara, Leticia, Cristina Fernández-Baizán, Lara González-García, Enrique García-López, Clara González-López, Jorge Luis Arias, Marta Méndez, and Gonzalo Solís Sánchez. 2021. "Neuropsychological Development and New Criteria for Extrauterine Growth Restriction in Very Low-Birth-Weight Children" Children 8, no. 11: 955. https://0-doi-org.brum.beds.ac.uk/10.3390/children8110955