ABSTRACT
AIM: The purpose of the present contribution is to analyse the relationships between perinatal risk factors, social parameters and neurodevelopmental outcomes in extremely low-birth-weight (ELBW) children up to the age of 10-13 years. METHODS: Of 200 live-born ELBW infants, 148 were enrolled in the high-risk infant follow-up programme. Each follow-up visit included a neurodevelopmental examination and an interview with the infant's parents. Multivariate analyses using SPSS (version 17.0, Chicago, IL, USA) were conducted, and a p-value of <0.05 indicated a statistically significant result. RESULTS: The results of the logistic regression analysis of the biological and sociodemographic risk factors illustrated that a low maternal educational background is the most important factor (OR, 21.9) associated with a decreased composite intelligence quotient (IQ) in children between 10 and 13 years old. A Grade III or Grade IV intraventricular haemorrhage (IVH) or periventricular leukomalacia (PVL) were also associated with decreased IQ at the age of 10-13 years (OR, 6.9). These results were confirmed by ANOVAs with repeated measurements. CONCLUSION: Maternal educational background is the strongest predictor of long-term neurodevelopment in ELBW children. The findings emphasize the need for special support and follow-up care services for poorly educated parents.
Subject(s)
Child Development , Cognition , Infant, Extremely Low Birth Weight/growth & development , Mothers , Adolescent , Child , Educational Status , Female , Follow-Up Studies , Humans , Infant, Newborn , Retrospective Studies , Risk Factors , Time FactorsABSTRACT
A randomized controlled trial (RCT) was conducted to assess the effectiveness of the home visiting program "Pro Kind". A total of 755 primiparae with multiple risk factors were recruited through the end of 2009 in three German federal states (Lower Saxony, Bremen, Saxony) and were randomized into one of two research groups. All participants had access to standard community service; women in the treatment group also received a program of home visitation over a period of 2.5 years. Primary objectives were improvement of maternal health behavior during pregnancy and birth of a healthy child. Long-term objectives are better outcomes of child health and development. To date, significant group differences in the primary objective variables are not detectable. Interim analyses at the ages of 6 and 12 months showed a tendency for a positive treatment effect on cognitive development. Methodological and practical limitations are critically discussed.
