Neurodevelopmental outcome of preterm infants discharged from NICU at 1 year of age and the effects of intervention compliance on neurodevelopmental outcome / 中国当代儿科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the neurodevelopmental outcome of preterm infants who were discharged from neonatal intensive care unit (NICU) at 1 year of age and the impact factors contributing to the neurodevelopmental outcome and to study whether early intervention can improve the neurodevelopmental outcome in preterm infants.</p><p><b>METHODS</b>Early intervention guidance and follow-up visits were performed after the preterm infants discharged from NICU. The infants received the infant development test of Child Development Centre of China (CDCC) for neurological development at 1 year of age. The neurodevelopmental outcome was evaluated based on mental development index (MDI) and physical development index (PDI). MDI and PDI > 85 was defined as normal, MDI or PDI between 70 and 85 as critical and MDI or PDI < 70 as abnormal. Social-domestic and clinical factors related to neurological development were analyzed by ANOVA or chi-square test. Potential high risk factors were analyzed with logistic regression. To investigate the effects of intervention compliance on neurological development, the infants were classified into two groups according to different intervention compliances. The good compliance group included infants who received a through familial intervention for more than 4 days weekly (30 minutes daily) and consulted with physicians more than 5 times in 1 year. The infants who did not receive the interventions as the good compliance group served as the bad compliance group.</p><p><b>RESULTS</b>This study consisted of 210 infants, with a mean gestational age of 33.2 +/- 2.6 weeks and a mean birth weight of 1923.3 +/- 558.8 g. Normal, critical and abnormal neurological development occurred in 123 cases (58.6%), 61 cases (29.0%) and 26 cases (12.4%) respectively. Eighteen infants (8.6%) had mental lag and 9 (4.3%) had cerebral palsy (CP). The MDI and PDI scores of the good compliance group (111 cases) were 97.15 +/- 17.38 and 94.23 +/- 18.55 respectively, which were markedly higher than those of the bad compliance group (89.87 +/-18.92 and 87.20 +/-19.12; P < 0.05). The incidence of CP (3/111, 2.7%) in the good compliance group was lower than that of the bad compliance group (5/99, 6.1%) although there were no statistical differences. Parents' education level, multiple birth, serious intracranial hemorrhage and apnea were risk factors for adverse neurodevelopmental outcome.</p><p><b>CONCLUSIONS</b>Preterm infants discharged from NICU are a high risk group of neurodevelopmental disablement. Early intervention can improve the neurodevelopmental outcome of perterm infants at high risk.</p>