Neonatal Factors Associated with a Good Neurodevelopmental Outcome in Very Preterm Infants

Am J Perinatol. 2017 Mar;34(4):388-396. doi: 10.1055/s-0036-1592129. Epub 2016 Sep 2.

Abstract

Objective This study aims to examine the association between the absence of neonatal comorbidities, as well as the presence of indicators of clinical progress with good neurodevelopmental (ND) outcomes, at 18 months corrected age in a national cohort of preterm infants of < 29 weeks' gestation. Design Study subjects included preterm infants (< 29 weeks' gestation) born in 2010 and 2011. Univariate analyses were conducted and regression estimates were calculated for variables where odds of a good ND outcome, composite scores ≥ 100 in three domains (cognitive, language, and motor) in the Bayley Scales of Infant and Toddler Development, 3rd ed. (Bayley-III), were estimated. Results In total, 2,069 infants were included in the analyses. For all three domains evaluated on the Bayley-III, cognition, language, motor, respectively, the absence of three major morbidities was associated with a score ≥ 100: bronchopulmonary dysplasia, necrotizing enterocolitis, and severe neurological injury. Less time spent on positive pressure support and on total parenteral nutrition administration were associated with a positive motor outcome and showed a positive trend for both cognition and language scores. Conclusion The absence of neonatal comorbidities was associated with good ND outcome. Less time spent on positive pressure support and parenteral nutrition may also contribute to a good ND outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bronchopulmonary Dysplasia / epidemiology
  • Bronchopulmonary Dysplasia / physiopathology
  • Cognition*
  • Comorbidity
  • Enterocolitis, Necrotizing / epidemiology
  • Enterocolitis, Necrotizing / physiopathology
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • Language Development*
  • Male
  • Motor Skills*
  • Parenteral Nutrition, Total
  • Positive-Pressure Respiration
  • Pregnancy
  • Premature Birth / epidemiology*
  • Premature Birth / physiopathology
  • Time Factors
  • Trauma, Nervous System / epidemiology
  • Trauma, Nervous System / physiopathology

Grant support