Corioamnionitis histológica y neurodesarrollo en niños prematuros menores de 34 semanas, Lima-Perú

Para determinar los efectos de la corioamnionitis histológica en el neurodesarrollo de los prematuros menores de 34 semanas evaluados a los 2 años de edad corregida se realizó un estudio secundario de casos y controles. Fueron analizados los datos clínicos, hallazgos histológicos de la placenta e índices del desarrollo medidos por la Escala Bayley III de 38 niños expuestos y 53 niños no expuestos. Las infecciones genitourinarias de la madre y la sepsis precoz fueron más frecuentes en el grupo expuesto (p<0,005). Las dimensiones del desarrollo cognitivo, motor y lenguaje fueron normales en ambos grupos. Los expuestos al subtipo subcorionitis obtuvieron menor desempeño en las tres dimensiones. La corioamnionitis histológica no mostró influencia sobre el neurodesarrollo en prematuros menores de 34 semanas a los 2 años de edad. Se recomienda estudios longitudinales y multicéntricos para definir los efectos a largo plazo.

SUMMARY The objective of this study was to determine the effects of histologically diagnosed chorioamnionitis on neurodevelopment of premature babies born with less than 34-week gestational age who were assessed at two-year corrected age. A secondary case-control study was carried out. Clinical data, placental histological findings, and development indexes assessed using the Bayley III scale were analyzed in 38 exposed children and 53 non-exposed children. Genitourinary infections in mothers and early sepsis were more frequent in the exposed group (p<0.005). Cognitive development, motor development and language were normal in both groups. Those children exposed to the chorionitis subtype had lower scores in the aforementioned variables. Histologically diagnosed chorioamnionitis did not show any influence on neurodevelopment in premature babies born with less than 34-week gestational age when they were assessed at two years. Longitudinal and multicenter studies are advised in order to define the long-term effects.

Uso da Escala de Avaliação do Desenvolvimento Infantil Bayley III em Crianças Brasileiras: Revisão Sistemática / Use of the Bayley III Child Development Rating Scale in Brazilian Children: A Systematic Review

Resumo O objetivo deste estudo foi realizar uma revisão sistemática de pesquisas com a Escala Bayley-III em crianças brasileiras. Foram seguidas as recomendações PRISMA, com buscas nas bases MEDLINE, LILACS, SCIELO, Scopus, PUBMED e Web of Science. A revisão incluiu artigos publicados nos idiomas português e inglês entre 2006 e 2018. Foram encontrados 856 estudos e, após análise do título e resumo, selecionaram-se 24. Os estudos avaliaram o desenvolvimento de crianças prematuras, típicas, frequentadoras de creche, e atípicas,sendo a maioria residente na região Sudeste e com até 12 meses de idade. A literatura apontou a prevalência de fatores de risco e altos percentuais de suspeitas e atrasos do desenvolvimento neuropsicomotor entre as crianças brasileiras avaliadas.

Abstract The objective of this study was to conduct a systematic review of Bayley III scale surveys in Brazilian children. The PRISMA recommendations were followed, with searches in the MEDLINE, LILACS, SCIELO, Scopus, PUBMED and Web of Science databases. The review included articles published in the Portuguese and English languages between 2006 and 2018. A total of 856 studies were found after the title and abstract analysis, and 24 were selected. The studies evaluated the development of preterm, typical, daycare, and atypical children, being the majority resident in the Southeast region and up to 12 months of age. The literature pointed to the prevalence of risk factors and high percentages of suspected and delayed neuropsychomotor development among the Brazilian children evaluated.

Influence of type of birth on child development: a comparison by Bayley- III Scale / A influência da via de parto no desenvolvimento infantil: uma comparação por meio da Bayley-III

INTRODUCTION: Elective cesarean section is associated with several damages to the newborn's health, such as respiratory, gastrointestinal problems and diabetes that last throughout life. However, few studies discuss aspects related to psychological developmentOBJECTIVE: To investigate the development of Brazilian children according to the type of birth and gestational age in the cognitive, language, motor, socio-emotional and adaptive behavior domainsMETHODS: This is an exploratory and descriptive cross-sectional study conducted in the city of São Bernardo do Campo, São Paulo, Brazil, between June 2016 and March 2017. The final sample consisted of 263 children up to 42 months of age. For data collection were applied a socio demographic questionnaire and the Bayley-III Scale. The statistical analysis was based on both a North American reference sample and a local sample using the SPSS version 21, through Pearson's Chi-square statistical test and significance criteria p <0.05RESULTS: A significant difference (p<0.005) was observed, with a higher risk of problems in fine motor development and expressive language in children born at pre-term between 37- 39 weeks compared to those born at term between 39 - 41 weeks. Significant difference (p<0.005) was also observed in sensory processing and adaptive behavior, with greater impairment in children born via elective cesarean section compared to those born vaginallyCONCLUSION: Despite its limitations and discrepancies, this research indicates potential impairments in the psychological development of children born at early term via elective cesarean

INTRODUÇÃO: A cesárea eletiva está associada a diversos prejuízos à saúde do recém-nascido, como problemas respiratórios, gastrointestinais e diabetes, que perduram ao longo da vida. No entanto, poucos estudos discutem os aspectos relacionados ao desenvolvimento psicológicoOBJETIVO: Investigar o desenvolvimento de crianças brasileiras segundo a via de parto e a idade gestacional nos domínios cognitivo, linguagem, motor, socioemocional e comportamento adaptativoMÉTODO: Trata-se de um estudo exploratório-descritivo, transversal, realizado no município de São Bernardo do Campo, entre junho de 2016 e março de 2017. A população foi composta por 400 crianças até 42 meses de idade. Para coleta de dados foram aplicados questionário sociodemográfico e Escala Bayley-III. Foi utilizada para análise estatística tanto a normatização oferecida pela Escala Bayley (norte-americana) quanto a normatização referente à amostra estudada, por meio do SPSS version 21, utilizando o teste estatístico do Qui-Quadrado de Pearson, critérios de significância p<0,05RESULTADOS: Observou-se diferença significativa (p<0,005), com maior risco de problemas no desenvolvimento motor fino e na linguagem expressiva em crianças nascidas a termo precoce (37 a<39 semanas) quando comparadas às nascidas a termo (=39 a <41 semanas). Diferença significativa (p<0,005) também foi observada no processamento sensorial e comportamento adaptativo, com maior prejuízo observado nas crianças nascidas via CE em comparação às nascidas de parto vaginalCONCLUSÃO: Este estudo evidencia o aumento de riscos psicológicos em crianças nascidas via cesárea eletiva quando comparadas com as nascidas por parto vaginal nos aspectos relacionados ao processamento sensorial, motricidade fina, linguagem expressiva e emissão de comportamentos adaptativos

A prospective study to determine etiology, clinical profile and neurodevelopmental outcome of neonatal seizures admitted in newborn unit of Chengalpattu Medical College and Hospital, Tamil Nadu, India

Background: Newborn with neonatal seizures is at risk of neurodevelopmental delay. The aim of this study was to determine the factors affecting the adverse outcome of neonatal seizures and to study the significant factors associated with poor neurodevelopmental outcome in neonatal seizures.Methods: This was a prospective study done at neonatal intensive care unit (NICU) in Chengalpattu Medical College during the period from June 2017 to September 2018. A total of 110 neonates with seizures admitted in NICU from first hour of life to 28 days of age were included in the study. Detailed history was collected in preformed proforma, and followed up to one year and neurological assessment done at 4th month, 8th month and 1 year. The Hammersmith infant neurological examination (HINE) was done at 4 and 8 month and the Bayley'III assessment was done at 1 year of age to determine the neurodevelopment outcome.Results: Out of 110 newborns with seizures, 86 cases were followed up to 1 year of age. Neurological assessment done by HINE determined abnormal neurodevelopment in 33.6% neonates. Bayley-III scale assessment found cognitive delay in 10.9%, language delay in 20%, motor delay in 5.55%, socio-emotional delay in 30%, and adoptive delay in 31.8% cases. Delayed developmental outcome is significantly associated with onset of seizures, frequency of seizure, poor 5 minute Apgar score, abnormal EEG, and hypoxic ischemic encephalopathy (HIE).Conclusions: The delayed developmental outcome high among the neonates with subtle and myoclonic seizures. Mortality and neurological impairment was after neonatal seizure is associated with Onset and frequency of seizures, low Apgar score at 5 min, findings of USG cranium, CT brain, EEG, and HIE.

Comparação de habilidades cognitivas de crianças a termo e pré-termo / Comparison of cognitive skills of children to term and pre-term / Comparación de habilidades cognitivas de niños a término y pre-término

Introdução: A cognição é um conjunto de habilidades mentais essenciais para se adquirir conhecimento. É durante os três primeiros anos de vida que ocorrem os grandes avanços no desenvolvimento cognitivo. Este desenvolvimento está diretamente ligado aos aspectos nutricionais, socioeconômicos, nível educacional da família e à dinâmica familiar. Crianças pré-termo têm risco para alteração no processo do desenvolvimento cognitivo. Objetivo: Verificar o desempenho cognitivo em 20 crianças pré-termo. Método: É um estudo observacional e transversal. A amostra foi composta por 20 crianças nascidas a termo e 20 nascidas pré-termo. Os responsáveis pelas crianças responderam a um questionário contendo informações referentes à história clínica do participante e dados socieconômicos. Foi aplicada a subparte da escala Bayley III referente às habilidades cognitivas. A análise dos dados foi realizada pelo teste estatístico de Mann-Whitney, apresentados em dados quantitativos de médias, desvio padrão e alfa (p-valor). Resultados: Ao analisar as pontuações das habilidades cognitivas dos grupos observou-se que 16 crianças (80%) encontravam-se com pontuações abaixo da média, 1 (5%) na média e 3 (15%) acima da média esperada para a idade. O grupo pré-termo obteve 13 crianças (65%) com pontuações abaixo da média, 1 (5%) na média e 6 (30%) acima da média, notando-se que o grupo pré-termo apresentou melhores resultados. Não houve diferença significativa entre as médias dos dois grupos do presente estudo em relação a nenhuma das variáveis. Conclusão: Não houve diferença estatística no desempenho cognitivo entre os grupos nesta faixa etária. Deve-se considerar que os desempenhos dos participantes poderão mudar em outra faixa etária.

Introduction: Cognition is a set of mental skills essential to acquiring knowledge. It is during the first three years of life that great advances in cognitive development occur. This development is directly related to the nutritional, socioeconomic aspects, educational level of the family and family dynamics. Premature children are at risk for a change in the cognitive development process. Objective: To verify cognitive development in 20 preterm infants. Method: It is an observational and cross-sectional study. The sample consisted of 20 full-term infants and 20 preterm infants. Those responsible for the children answered a questionnaire, containing information regarding the participant's medical history and socioeconomic data. It was applied to the subpart of the Bayley III scale regarding cognitive abilities. Data analysis was performed using the Mann-Whitney statistical test, presented in quantitative data of means, standard deviation and alpha (p-value). Results: When analyzing the scores of the cognitive abilities of the groups it was observed that 16 children (80 %) had 2 below-average scores, 1 (5%) on average and 3 (15%) above the expected age-for-age. The preterm group obtained 13 children (65%) with below-average scores, 1 (5%) in the mean and 6 (30%) above the mean, noting that the premature group presented better results. There was no significant difference between the means of the two groups of the present study in relation to none of the variables. Conclusion: There was no statistical difference in cognitive performance between the groups in this age group. It should be considered that the performance of the participants may change in another age group.

Introducción: La cognición es un conjunto de habilidades mentales esenciales para adquirir conocimiento. Es durante los tres primeros años de vida que ocurren los grandes avances en el desarrollo cognitivo. Este desarrollo está directamente ligado a los aspectos nutricionales, socioeconómicos, nivel educativo de la familia y la estimulación favorecida en la relación familiar. Los niños prematuros tienen valor predictivo para cambiar el proceso en el desarrollo cognitivo. Objetivo: Verificar el desarrollo cognitivo en 20 niños prematuros. Método: Es un estudio observacional y transversal. La muestra fue compuesta por 20 niños nacidos a término y 20 nacidos de pre-término. Los responsables de los niños respondieron a un cuestionario, conteniendo informaciones referentes a la historia clínica del participante y datos socieconómicos. Se aplica la prueba equivalente a las habilidades cognitivas de la escala Bayley III. El análisis de los datos fue realizado por los test estadísticos de Mann-Whitney, presentados en datos cuantitativos de promedios, desviación estándar y alfa (p-valor). Resultados: Al analizar las puntuaciones de las habilidades cognitivas de los grupos se observó que 16 niños (80%) se encontraban con puntuaciones por debajo de la media, 1 (5%) en la media y 3 (15%) por encima de la media esperada para la edad. El grupo anterior cuenta con 13 niños (65%) con puntuaciones por debajo de la media, 1 (5%) en la media y 6 (30%) por encima de la media, notando que el grupo prematuro presentó mejores resultados. En el diferencial diferencia significativa entre las medias de los de los grupos del presente estudio en relación a varias de las variables. Conclusión: En el intervalo diferencia estadística en el ritmo cognitivo de los de los grupos en este grupo de edad. Se debe considerar que estos resultados pueden cambiar en otro grupo de edad infantil.

The Bayley-III Adaptive Behavior and Social-Emotional Scales as Important Predictors of Later School-Age Outcomes of Children Born Preterm

PURPOSE: We aim to assess the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), Adaptive Behavior (AB) and Social-Emotional (SE) scales at 18 to 24 months of corrected age (CA) to examine their associations with school-age cognitive and behavioral outcomes in children born preterm. METHODS: Eighty-eight infants born with a very low birth weight ( < 1,500 g) or a gestational age of less than 32 weeks who were admitted to the neonatal intensive care unit from 2008 to 2009 were included. Of the 88 children who completed school-age tests at 6 to 8 years of age, 37 were assessed using the Bayley-III, including the AB and SE scales, at 18 to 24 months of CA. Correlation, cross-tabulation, and receiver operating characteristic analyses were performed to assess the longitudinal associations. RESULTS: A significant association was observed between communication scores on the Bayley-III AB scale at 18 to 24 months of CA and the Korean version of the Wechsler Intelligence Scale for Children (K-WISC) full-scale intelligence quotient (FSIQ) at school age (r=0.531). The total behavior problem scores of the Korean version of the Child Behavior Checklist (K-CBCL) at school age were significantly negatively related to the Bayley-III SE and AB scales but not to the cognitive, language, or motor scales. CONCLUSION: Our findings encourage AB and SE assessments during the toddler stage and have important implications for the early identification of children in need of intervention and the establishment of guidelines for follow-up with high-risk infants.

Comparison of Second and Third Editions of the Bayley Scales in Children With Suspected Developmental Delay

OBJECTIVE: To compare the scores of the Bayley Scales of Infant Development second edition (BSID-II) and the third edition, Bayley-III, in children with suspected developmental delay and to determine the cutoff score for developmental delay in the Bayley-III. METHODS: Children younger than 42 months (n=62) with suspected developmental delay who visited our department between 2014 and 2015 were assessed with both the BSID-II and Bayley-III tests. RESULTS: The mean Bayley-III Cognitive Language Composite (CLC) score was 5.8 points higher than the mean BSID-II Mental Developmental Index (MDI) score, and the mean Bayley-III Motor Composite (MC) score was 7.9 points higher than the mean BSID-II Psychomotor Developmental Index (PDI) score. In receiver operating characteristic (ROC) analysis of a BSID-II MDI score < 70, Bayley-III CLC scores showed a cutoff of 78.0 (96.6% sensitivity and 93.9% specificity). In ROC analysis of a BSID-II PDI score < 70, the Bayley-III MC score showed a cutoff of 80. CONCLUSION: There was a strong correlation between the BSID-II and Bayley-III in children with suspected developmental delay. The Bayley-III identified fewer children with developmental delay. The recommended cutoff value for developmental delay increased from a BSID-II score of 70 to a Bayley-III CLC score of 78 and Bayley-III MC score of 80.