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Objective To analyze the risk factors of adverse neurodevelopmental prognostic in very/extremely low birth weight infants (VLBWI/ELBWI).Methods The 24 hours VLBWI/ELBWI admitted to the neonatal intensive care unit between January 2016 and October 2016 were enrolled.These infants were followed up and neurodevelopmental evaluation was performed at a corrected age of 12 months by using the Bayley Scales of Infant Development Ⅱ (BSID-Ⅱ).According to the neurodevelopmental outcomes,they were divided into normal and abnormal neurodevelopment groups.The data of prenatal,intrapartum and postpartum periods in the two groups were compared.Potential risk factors of neurodevelopmental impairment were analyzed with Logistic stepwise regression.Results A total of 167 VLBWI/ELBWI were enrolled,among which 14 cases died during hospitalization or after giving up treatment.At the corrected age of 12 months,140(91.5％) infants completed follow-up and 13(8.5％) were lost to follow-up.Among 140 infants who completed neurodevelopmental evaluation at the corrected age of 12 months,there were 86 males,54 females,and in which 28 cases had extremely low birth weight,112 cases with very low birth weight,with gestational age of (30.4 ± 2.2) weeks (25.3-36.0 weeks).There were one hundred and twenty-five cases with normal neurodevelopmental outcomes and 15 cases with abnormal neurodevelopmental outcomes.The results of univariate analysis showed that birth weight ＜ 1 000 g,exposure to antenatal steroids,N-terminal brain natriuretic peptide (NT-proBNP) ≥35 000 ng/L and bronchopulmonary dysplasia (BPD) in the two groups were statistically significant (P ＜ 0.05).Logistic stepwise regression showed that NT-proBNP level ≥ 35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI (OR =22.774,95％ CI:3.079-168.425,P =0.002).Exposure to antenatal steroids may be a protective factor for neurodevelopmental impairment (OR =0.125,95％ CI:0.020-0.782,P =0.026).Conclusions Plasma NT-proBNP level ≥ 35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI.Antenatal corticosteroids may be the protective factor of poor neurodevelopmental outcomes.
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Objective@#To analyze the risk factors of adverse neurodevelopmental prognostic in very /extremely low birth weight infants (VLBWI/ELBWI).@*Methods@#The 24 hours VLBWI/ELBWI admitted to the neonatal intensive care unit between January 2016 and October 2016 were enrolled.These infants were followed up and neurodevelopmental evaluation was performed at a corrected age of 12 months by using the Bayley Scales of Infant Development Ⅱ (BSID-Ⅱ). According to the neurodevelopmental outcomes, they were divided into normal and abnormal neurodeve-lopment groups.The data of prenatal, intrapartum and postpartum periods in the two groups were compared.Potential risk factors of neurodevelopmental impairment were analyzed with Logistic stepwise regression.@*Results@#A total of 167 VLBWI/ELBWI were enrolled, among which 14 cases died during hospitalization or after giving up treatment.At the corrected age of 12 months, 140(91.5%) infants completed follow-up and 13(8.5%) were lost to follow-up.Among 140 infants who completed neurodevelopmental evaluation at the corrected age of 12 months, there were 86 males, 54 females, and in which 28 cases had extremely low birth weight, 112 cases with very low birth weight, with gestational age of (30.4±2.2) weeks (25.3-36.0 weeks). There were one hundred and twenty-five cases with normal neurodevelopmental outcomes and 15 cases with abnormal neurodevelopmental outcomes.The results of univariate analysis showed that birth weight<1 000 g, exposure to antenatal steroids, N -terminal brain natriuretic peptide (NT-proBNP) ≥35 000 ng/L and bronchopulmonary dysplasia (BPD) in the two groups were statistically significant(P<0.05). Logistic stepwise regression showed that NT-proBNP level≥35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI (OR=22.774, 95%CI: 3.079-168.425, P=0.002). Exposure to antenatal steroids may be a protective factor for neurodevelopmental impairment (OR=0.125, 95%CI: 0.020-0.782, P=0.026).@*Conclusions@#Plasma NT-proBNP level ≥35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI.Antenatal corticosteroids may be the protective factor of poor neurodevelopmental outcomes.
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Objective To investigate the trend of early neural development in premature infants. Methods At the age of 12 months and 24 months, Bayley Scales of Infant Development were used to assess the mental development index (MDI) and the psychomotor development index (PDI) in preterm (corrected age) and full-term infants. Results At 12 months, there was no significant difference in corrected age PDI scores among different gestational age groups (<32 , 32–33+6 and 34–36+6 weeks) (P=0.820). The actual age MDI and PDI scores of full-term infants and premature infants in 34~36+6 weeks group were significantly higher than those of premature infants in <32 and 32-33+6 weeks groups, and the PDI score of full-term infants was significantly higher than that of premature infants in 34-36+6 weeks group (P<0.05). There was no significant difference in actual age PDI scores among different birth weight groups (P=0.166). The actual age MDI and PDI of full-term infants and premature infants in birth weight≥2500 g group were significantly higher than those of premature infants in <1500 g, 1500~1999 g and 2000~2499 g groups (P<0.05). At 24 months, the actual age MDI scores of full-term infants were significantly higher than those of premature infants in different gestational age and birth weight groups (P<0.05). The actual age MDI curve of premature infants in birth weight <1500g group showed a downward trend, while the actual age PDI curve showed a significant upward trend. Conclusion The neurodevelopment of preterm infants at the corrected age of 12 and 24 months reaches the level of full-term infants.
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We investigated the association between breastfeeding and cognitive development in infants during their first 3 years. The present study was a part of the Mothers' and Children's Environmental Health (MOCEH) study, which was a multi-center birth cohort project in Korea that began in 2006. A total of 697 infants were tested at age 12, 24, and 36 months using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II). The use and duration of breastfeeding and formula feeding were measured. The relationship between breastfeeding and the mental development index (MDI) score was analyzed by multiple linear regression analysis. The results indicated a positive correlation between breastfeeding duration and MDI score. After adjusting for covariates, infants who were breastfed for ≥ 9 months had significantly better cognitive development than those who had not been breastfed. These results suggest that the longer duration of breastfeeding improves cognitive development in infants.
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Adult , Child, Preschool , Female , Humans , Infant , Male , Breast Feeding , Child Development/physiology , Cognition/physiology , Demography , Follow-Up Studies , Interviews as Topic , Linear Models , Mothers/psychology , Multivariate Analysis , Program Evaluation , Prospective Studies , Republic of KoreaABSTRACT
Objective To study the neurodevelopmental outcome prospectively at 18 months of the late preterm infants.Methods Data from 7 584 live born neonates were collected between January and December.2009 in 3 hospitals located in the north of Chengdu City,Sichuan Province were collected,89 late preterm infants were brought into study ; 170 healthy full-term infants were chosen as the controls randomly.Neurodevelopment outcome was assessed by using neonatal behavioral neurological assessment(NBNA) at 40 weeks corrected gestational age,and Bayley scales of infant development was performed to obtain the physical development index (PDI) and mental development index (MDI) at 3,6,9,12 and 18 months corrected age.Neurodevelopmental outcome of late preterm infants was studied compared with that of the term infants.Results Sixty-three neonates born at the late preterm phase and 115 neonates born at the term phase were successfully followed up.The NBNA scores of the late preterm infants at 40 weeks corrected gestationa] age were significantly lower than those of the term infants.The proportion of the late preterm infants whose scores ≥37 was significantly lower than that of the term infants(82.5％ vs 94.8％),the proportion of late preterm infants whose scores ＜35 was significantly higher than that of the term infants(4.8％ vs 0),the proportion of the late preterm infants whose scores in 35-36 was significantly higher than that of the term infants (12.7％ vs 5.2％,Z =-2.707,P ＜ 0.05) ;At 3,6,9 and 12 months corrected age,the late preterm infants showed a significant lower PDI scores(t =-4.266,-4.594,-5.663,-2.584) and MDI scores (t =-7.121,-7.829,-7.038,-6.002) than those of the term infants(all P ＜0.05).Compared with the term infants,the late preterm infants still had lower MDI scores than the term infants at 18 months corrected age(t =-4.115,P ＜0.05),but no difference was observed in PDI scores between late preterm and the term infants (t =-0.957,P ＞ 0.05).Conclusions Neurodevelopment outcome of the late preterm infants is delayed in the first year compared with term infants.At 18 months corrected age the mental development is still delayed compared with the term infants.Measures should be taken properly to improve the neurodevelopment of the late preterm infants in the early childhood.
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Objective To investigate the intelligence development status of the low birth weight infants and its influence factors. Methods The intelligence developments of 135 low birth weight infants aged 6-30 months were investigated using Bayley Scales of Infant Development, and the self-development influential factors were analyzed with questionnaire.Results The average of MDI was 86.76±18.95 in 135 infants,of which the detection rate of MDI<80 points accounted for 17.8%and the detection rate of PDI<80 points accounted for 29.6%;birth weight of infant,age,the degree of parents,culture and feeding way had significant effects on MDI in infants;age and birth weight had significant effects on PDI in infants. Conclusion The development level of infants is influenced by multi-factors. More attention should be paid to reduce premature and low birth weight infants,improve the degree of parents' culture, advocate breastfeeding and conduct early intervention in order to assure the intelligence development of infants.
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OBJECTIVE: To assess the relationship of scores on the test of infant motor performance (TIMP), with those on the Bayley scales of infant development (BSID), and to investigate the sensitivity and specificity of TIMP and the optimal cut-off value of TIMP scores using ROC analysis. METHOD: Seventy-six preterm and term infants were recruited from neonatal intensive care units. Subjects were tested with the TIMP at their initial visit and after 6 months, they were tested by using BSID. RESULTS: In the reliability study, TIMP scores showed highly significant correlation with the Bayley physical developmental index (BPDI) (p=0.001) and Bayley mental developmental index (BMDI) (p=0.017). Receiver operator characteristics (ROC) curve analysis was performed to evaluate the TIMP test for screening infant motor development. ROC analysis showed an area under the curve (AUC) of 0.825 (p=0.005) in BPDI and 0.992 (p=0.014) in BMDI, indicating an excellent classification performance of the model. The optimal cut-off value where a sensitivity of 86%, and specificity of 68% were achieved with the TIMP was 1.50 (between average and below average) in BPDI and where a sensitivity of 100%, and specificity of 66% were achieved with the TIMP was 1.50 in BMDI. CONCLUSION: Our results indicate that the TIMP provides a reliable and valid measurement that can be used for the evaluation of motor function in preterm and term infants. TIMP was highly sensitive and specific with the follow-up examination of BSID. Therefore it can be used as a reliable screening tool for neonates and infants aged <4 months.
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Aged , Child , Humans , Infant , Infant, Newborn , Child Development , Follow-Up Studies , Intensive Care Units, Neonatal , Mass Screening , ROC Curve , Sensitivity and Specificity , Weights and MeasuresABSTRACT
PURPOSE: Ages & Stages Questionnaires (K-ASQ, parents report of developmental skills) was used as a screening tool for detecting infant and young children with developmental disorder in National Health Screening Program. This study was designed for validating the effectiveness of K-ASQ in the assessment of children with developmental delay. METHODS: One hundred twenty-nine children(male: 94, female: 35, age: 8-39 months) with suspected developmental delay, who visited the department of Pediatrics in Catholic University of Daegu Hospital from January 2008 to August 2009 were enrolled. They were classified into three groups according to Mental Developmental Index of Bayley Scales of Infant Development test II(BSID II)(Group I: MDI or =85: within normal range), and compared with the result of K-ASQ. RESULTS: Group I was eighty-one children. Group II was thirty-eight children. The scores of eighty children of Group I and thirty-three children of Group II fall below a given cut off score in one or more domains in K-ASQ. One child's score of group I didn't fall below a given cut off score but was adjacent to a given cut off score. Five children's scores of group II didn't fall below a given cut off score. Only three children's score of these five were adjacent to a given cut off score. CONCLUSION: There was relatively high correlation between the results of K-ASQ and BSID-II for infants and children with developmental delay. Our results suggest that the referral for further developmental evaluation is recommended if the scores showed below or adjacent to a given cut off score in any domain in K-ASQ.
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Child , Humans , Infant , Child Development , Mass Screening , Parents , Pediatrics , Surveys and Questionnaires , Referral and Consultation , Weights and MeasuresABSTRACT
PURPOSE: The aim of this study was to analyze the results and contributing factors of catch-up growth in very low birth weight infants(VLBWI) at the corrected age of 2 years. In addition, we looked for a relationship between the catch-up growth and the development by the bayley scales of infant development II(BSID II). METHODS: A retrospective analysis by evaluating medical records was done for the 76 VLBWI whose follow-up was possible up to a corrected age of 2 years, out of the 114 who had been treated in the neonatal intensive care unit during the January of 2000 to December of 2001 at Samsung Cheil Hospital. Based on the Standard Korean Infant's Growth Curve, the catch-up growth group was defined over the 10th percentile of weight at 2 years as the corrected age and the failed catch-up growth group was defined under the 10th percentile. We investigated the clinical factors and courses of each group and compared the scores of the BSID II. RESULTS: The catch-up growth group of the VLBWI was 51 infants and the failed catch-up growth group was 25 infants. In comparison with maternal clinical factors, use of antenatal steroids was significantly higher in the catch-up growth group. In comparisn with clinical factors and courses of VLBWI, two clinical factors were significantly different between the two groups: birth weight and intrauterine growth retardation(IUGR). Numbers of delayed development were increased in the failed catch-up growth group but statistically significant differences could not be observed. CONCLUSION: The catch-up growth of the VLBWI was affected by the use of antenatal steroids, birth weight and IUGR. No significant differences regarding neurodevelopmental outcome were observed between the catch-up and failed catch-up growth groups.
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Child , Humans , Infant , Infant, Newborn , Birth Weight , Child Development , Fetal Growth Retardation , Follow-Up Studies , Growth and Development , Infant, Very Low Birth Weight , Intensive Care, Neonatal , Medical Records , Retrospective Studies , Steroids , Weights and MeasuresABSTRACT
PURPOSE: Currently, there are many developmental tests of scale and screening for infants and children. However, it has been questioned about the discriminating power and the correlation among developmental tests of scale and screening. So we comprared the Bayley Scales of Infant Development-II(BSID-II) and Korean Infant and Child Developmental Test(KICDT) in terms of correlations and agreement. METHODS: Seventy two infants were studied, who visited the pediatric outpatient clinic at Cheonan Soonchunhyang University Hospital between December 2002 and September 2003. They were classified into three groups, group A of 24 full term infants, group B of 24 preterm infants, and group C of 24 disabled full term infants. We performed both tests to the all infants. RESULTS: The mean scores of mental and psychomotor developmental indices of BSID-II of group A were higher than those of group B and group C, which was statistically significant. Also, the mean scores of personal-social, language and cognitive- adaptive fields of KICDT of group A were much higher than those of group B and group C. The correlation coefficients between BSID-II and KICDT were high in many indices. The kappa coefficient by Cohen between BSID-II and KICDT is 0.45(0.24-0.66). CONCLUSION: There was a reasonable corrrelation between BSID-II and Korean infant and child developmental test in infants younger than 12 months. The kappa coefficient by Cohen between BSID-II and KICDT is not so good in this study. Further study is needed to standardize the items of KICDT.
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Child , Child , Humans , Infant , Infant, Newborn , Ambulatory Care Facilities , Child Development , Infant, Premature , Mass Screening , Weights and MeasuresABSTRACT
Objective To provide scientific evidences for improving children early integrated development,through analyzing the mental developmental status and characteristics of 322 cases of 2-year-old children in Nanjing.Methods Intelligence and motor development condition in 322 cases of 2-year-old children were assessed by using Bayley Scales of Infant Development test,and the assessed results were analyzed.Results 1.The incidences of the children whose mental development index(MDI)or psychomotor development index(PDI)were under 69 were 3.1% and 5.6%,respectively;2.The MDI mean score(114.34?19.65)was significantly higher than that of PDI(101.73?21.53)(t=9.71,P0.05).Conclusions The incidences of mental retardation in this study were consistent with the result reported by World Health Organization.There were differences between motor and intelligence development in children,as well as the intelligence development between male and female.Therefore,it should be implemented early childhood developmental screening in child health care.Parents should be given scientific guides about intelligence and motor development of children.
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PURPOSE: By rapid development of neonatal intensive care from 1960, we are able to expect the long survival of the very low birth weight infants. But, there were high risk of poor growth, neurodevelopmental delay, deafness, and blindness in very low birth weight infants. So, it is important to follow-up after discharge. We try to compare normal term infants with very low birth weight infants by evaluating growth and neurodevelopmental outcome from living very low birth weight infants to corrected 2 years age. METHODS: This study was performed on 55 very low birth weight infants with corrected age 6 months to 24 months who were admitted to the neonatal intensive care unit of Presbyterian Medical Center from August 1991 to December 1993 and 61 normal term infants with age 6 months to 24 months who had been born in Presbyterian Medical Center. We compared very low birth weight infants with normal term infants about growth and neurodevelopmental outcome at corrected age 6, 12, 18, 24 months. Weight, height and head circumference were measured. Developmental testing was performed using the BSID-II(Bayley scales of infant development, II). BSID-II test provide Mental Development Index (MDI) and Psychomotor Development Index(PDI). Motor handicap was graded as mild, moderate, or severe cerebral palsy. Sensorineural impairments were measured. RESULTS: 1) Very low birth weight infants were low in weight, height and head circumference compared with normal term infants to corrected 2 years age. But, most cases were above 10 percentile 2) Very low birth weight infants were in low in BSID-II's MDI(93.5+/-15.8) and PDI(91.3+/-17.9) compared with normal term infants. But, 76% of them were within normal range in MDI, 77% of them in PDI. 3) Seven patients of 55 very low birth weight infants had severe neurodevelopmental handicaps and three patients had severe cerebral palsy. CONCLUSIONS: We concluded that very low birth weight infants had significantly lower growth and BSID-II than normal term infants, but majority of very low birth weight infants belong to normal range.