TY - JOUR

T1 - Neurodevelopment at 2 years corrected age among Vietnamese preterm infants

AU - Do, Chuong Huu Thieu

AU - Kruse, Alexandra Yasmin

AU - Wills, Bridget

AU - Sabanathan, Saraswathy

AU - Clapham, Hannah

AU - Pedersen, Freddy Karup

AU - Pham, Thanh Ngoc

AU - Vu, Phuc Minh

AU - Børresen, Malene Landbo

N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

PY - 2020/2

Y1 - 2020/2

N2 - BACKGROUND: Preterm infants are at risk of neurodevelopmental delay, but data on long-term outcomes in low-income and middle-income countries remain scarce.OBJECTIVES: To examine neurodevelopment using Bayley Scales of Infant and Toddler Development-3rd edition (Bayley-III) and neurological findings in 2-year-old preterm infants, and to compare with healthy Vietnamese infants. Further, to assess factors associated with neurodevelopmental impairment.DESIGN AND SETTING: Cohort study to follow up preterm infants discharged from a neonatal intensive care unit (NICU) of a tertiary children's hospital in Vietnam.PARTICIPANTS: Infants born at <37 weeks of gestational age.MAIN OUTCOMES: Bayley-III assessment and neurological examination at 2-year corrected age (CA) compared with healthy Vietnamese infants.RESULTS: Of 294 NICU preterm infants, Bayley-III scores of all 184/243 (76%) survivors at 2 years CA were significantly lower than those of healthy Vietnamese peers in all three domains: cognition (mean (SD): 84.5 (8.6) vs 91.4 (7.5), p<0.001), language (mean (SD): 88.7 (12.5) vs 95.9 (11.9), p<0.001) and motor (mean (SD): 93.1 (9.0) vs 96.8 (9.3), p=0.003). The mean differences in Bayley-III scores between preterm and healthy Vietnamese infants were -6.9 (-9.1 to -4.7), -7.2 (-10.5 to -3.8) and -3.7 (-6.1 to -1.2) for cognitive, language and motor scores, respectively. The prevalence of neurodevelopmental impairment was 17% for cognitive, 8% for language and 4% for motor performance. In total, 7% were diagnosed with cerebral palsy. Higher maternal education was positively associated with infant neurodevelopment (OR 0.32, 95% CI 0.11 to 0.94).CONCLUSIONS: Vietnamese preterm infants in need of neonatal intensive care showed poor neurodevelopment at 2 years. Higher maternal education was positively associated with infant neurodevelopment. Standard follow-up programmes for preterm infants should be considered in low-resource settings.

AB - BACKGROUND: Preterm infants are at risk of neurodevelopmental delay, but data on long-term outcomes in low-income and middle-income countries remain scarce.OBJECTIVES: To examine neurodevelopment using Bayley Scales of Infant and Toddler Development-3rd edition (Bayley-III) and neurological findings in 2-year-old preterm infants, and to compare with healthy Vietnamese infants. Further, to assess factors associated with neurodevelopmental impairment.DESIGN AND SETTING: Cohort study to follow up preterm infants discharged from a neonatal intensive care unit (NICU) of a tertiary children's hospital in Vietnam.PARTICIPANTS: Infants born at <37 weeks of gestational age.MAIN OUTCOMES: Bayley-III assessment and neurological examination at 2-year corrected age (CA) compared with healthy Vietnamese infants.RESULTS: Of 294 NICU preterm infants, Bayley-III scores of all 184/243 (76%) survivors at 2 years CA were significantly lower than those of healthy Vietnamese peers in all three domains: cognition (mean (SD): 84.5 (8.6) vs 91.4 (7.5), p<0.001), language (mean (SD): 88.7 (12.5) vs 95.9 (11.9), p<0.001) and motor (mean (SD): 93.1 (9.0) vs 96.8 (9.3), p=0.003). The mean differences in Bayley-III scores between preterm and healthy Vietnamese infants were -6.9 (-9.1 to -4.7), -7.2 (-10.5 to -3.8) and -3.7 (-6.1 to -1.2) for cognitive, language and motor scores, respectively. The prevalence of neurodevelopmental impairment was 17% for cognitive, 8% for language and 4% for motor performance. In total, 7% were diagnosed with cerebral palsy. Higher maternal education was positively associated with infant neurodevelopment (OR 0.32, 95% CI 0.11 to 0.94).CONCLUSIONS: Vietnamese preterm infants in need of neonatal intensive care showed poor neurodevelopment at 2 years. Higher maternal education was positively associated with infant neurodevelopment. Standard follow-up programmes for preterm infants should be considered in low-resource settings.

KW - Brain/growth & development

KW - Child Development

KW - Child, Preschool

KW - Cohort Studies

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Infant, Premature/growth & development

KW - Male

KW - Neurodevelopmental Disorders/diagnosis

KW - Vietnam

U2 - 10.1136/archdischild-2019-316967

DO - 10.1136/archdischild-2019-316967

M3 - Journal article

C2 - 31300408

VL - 105

SP - 134

EP - 140

JO - Archives of Disease in Childhood: Fetal and Neonatal Edition

JF - Archives of Disease in Childhood: Fetal and Neonatal Edition

SN - 1359-2998

IS - 2

ER -