期刊
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
卷 121, 期 9, 页码 1804-1812出版社
ELSEVIER TAIWAN
DOI: 10.1016/j.jfma.2022.02.012
关键词
MDI; Neurodevelopment; PDI; Preterm; Very low birth weight
资金
- MacKay Memo- rial Hospital, Taiwan [MMH-E 107001]
The study aims to identify perinatal antecedents associated with neurodevelopmental impairment in very low birth weight preterm infants and evaluate the stability of neurodevelopmental assessments at different ages. The findings suggest that multiple perinatal risk factors are associated with poor neurodevelopmental scores in preterm infants, and the predictive ability of assessments at 6 months is limited for outcomes at 24 months.
Objective/Purpose: To identify perinatal antecedents associated with neurodevelopmental impairment for very low birth weight (VLBW) preterm infants at ages 6, 12, and 24 months and the stability of neurodevelopmental assessments.Methods: A multicenter-based VLBW cohort was recruited, and the mental development index (MDI) and psychomotor development index (PDI) were used to evaluate children's neurodevelopment stages at ages 6, 12, and 24 months. Perinatal risk factors were determined through univariate and multivariate hierarchical linear analyses. Differences and predictability in MDI or PDI scores between ages 6 and 24 months were assessed. infant's gestational age, gender, and birth weight <999 gm, duration of neonatal intensive care unit stay; and presence of various diseases were adversely associated with poor MDI or PDI scores in 8517 eligible VLBW infants during the study period. Polyhydramnios, emergency cesarean delivery, birth weight of <1250 gm, and periventricular/intraventricular hemorrhage stage I-II were additional risk factors of VLBW infants with an adverse PDI score. An increased number of infants with a MDI or PDI score of <55 at age 24 months was observed. Six-month MDI or PDI assessments had a low ability to predict outcomes at 24 months, with sensitivity and positive predictive values under 60% and specificity and negative predictive values over 85%.Conclusion: Multiple perinatal risk factors are associated with poor MDI and PDI scores among VLBW preterm infants. Six-month developmental assessments exhibited low sensitivity and positive predictive values for outcomes at 24 months.Copyright (c) 2022, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
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