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Neurodevelopment outcome of late prematurity: a retrospective cohort study from a developing country

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Abstract

The late preterm infants (34 0/7 to 36 6/7 weeks of gestation) account for at least 70% of all preterm birth. Our aim was to detect growth and neurodevelopment outcome, incidence of neurodevelopmental disability, and its association with maternal and neonatal risk factors among sick late preterm population. Two hundred and ninety-nine late preterm infants were followed up till corrected 2 years of age in this retrospective cohort study. Assessment was done by anthropometry and Developmental Assessment Scale for Indian Infants (DASII) scale at corrected 2 years of age. Presence of visual and hearing impairment, cerebral palsy, and overall neurodevelopmental impairment were also recorded. At 2 years of corrected age, average motor development quotient (DMoQ) was 93.55 (95% CI 90.9 to 96.20) and average mental development quotient (DMeQ) was 89.59 (95% CI 87.13 to 92.04). The incidence of bilateral severe to profound hearing loss and visual loss were found in 6 (2%) and 4 (1.33%) infants, respectively. Severe neurodevelopmental impairment was found in 19 (6.35%) infants. Central nervous system disease and sepsis were found as independent predictors of moderate to severe neurodevelopmental disability.

   Conclusion: Late preterm infants admitted in neonatal units were at risk of growth and neurodevelopmental impairment requiring close neurodevelopmental follow-up. In a resource limited setting, this may best be achieved by using DASII in follow-up clinic.

What is Known:

• Late preterm infants are at a high risk of prematurity-related morbidities.

• There is increased risk of cognitive defect, learning difficulties, and behavior problems found at school age for sick late preterm infants.

What is New:

• Central nervous system disease and sepsis were found as independent predictors of early moderate to severe neurodevelopmental impairment for sick late preterm infants in developing countries like India.

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Data Availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.

Abbreviations

ABER:

Automated auditory brainstem evoked response

ANOVA:

One-way analysis of variance

BERA:

Brain stem evoked response audiometry

CI:

Confidence interval

DASII:

Developmental Assessment Scale for Indian Infants

DMoQ:

Motor development quotient

DMeQ:

Mental development quotient

GMFCS:

Gross Motor Function Classification System

LMIC:

Low middle income countries

NEC:

Necrotizing enterocolitis

NICU:

Neonatal intensive care unit

OR:

Odds ratio

SCPE:

Surveillance of cerebral palsy in Europe

SD:

Standard deviation

SPSS:

Statistical Package for the Social Science

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Acknowledgements

We would like to thank all patients and doctors who participated in this study for their cooperation. We also would like to express our gratitude to all the staffs of neurodevelopment clinic of our department.

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Authors and Affiliations

  1. Department of Neonatology, Institute of Post Graduate Medical Education & Research, 244, A J C Bose Road, Kolkata, 700020, India

    Anindya Kumar Saha & Suchandra Mukherjee

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  1. Anindya Kumar Saha
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Contributions

Suchandra Mukherjee contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Anindya Kumar Saha and Suchandra Mukherjee. The first draft of the manuscript was written by Anindya Kumar Saha. Both the authors read and approved the final manuscript.

Corresponding author

Correspondence to Anindya Kumar Saha.

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Ethical approval

Ethical approval was obtained from Institutional Ethics Committee (vide IPGME&R/IEC/2018/574 dated 29.09.2018).

Consent to participate

Written informed consent was taken from caregiver/parents.

Competing interests

The authors declare no competing interests.

Additional information

Communicated by Daniele De Luca.

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Saha, A.K., Mukherjee, S. Neurodevelopment outcome of late prematurity: a retrospective cohort study from a developing country. Eur J Pediatr 182, 2715–2722 (2023). https://doi.org/10.1007/s00431-023-04953-x

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  • DOI: https://doi.org/10.1007/s00431-023-04953-x

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