Neurodevelopmental Impairment (neurodevelopmental + impairment)

Distribution by Scientific Domains


Selected Abstracts


Neurodevelopmental impairment: Predictors of its impact on the families of extremely low birth weight infants at 18 months,

INFANT MENTAL HEALTH JOURNAL, Issue 6 2008
Bonnie E. Stephens
Effects on a family of a child with chronic illness have been described. The Impact on Family Scale (IOF) was developed to measure these effects. The impact of extremely low birth weight (ELBW) infants with neurodevelopmental impairment on families is unknown. This study determined IOF scores for families of ELBW infants with increasing degree of impairment at 18 months and identified factors that increase vulnerability to impact. A total of 3,849 ELBW infant survivors born at the 16 centers of the National Institute of Child Health and Human Development Neonatal Research Network between January 1993 and February 2001 were assessed at 18 to 22 months. Infants were divided into four groups by degree of impairment. IOF scores were analyzed by impairment group. Multivariate analyses assessed effects of impairment, social/demographic factors, unmet service needs, and resource utilization on the IOF. A total of 1,624 (42.2%) infants had moderate/severe impairment. Increasing severity of impairment was associated with higher IOF scores. Severity of impairment contributed 6% of variance to the IOF scores. Twenty-one percent of variance was contributed by additional medical needs, low socioeconomic status (SES), and lack of social support. Although increasing severity of impairment impacts families of ELBW infants, significantly more impact is contributed by additional medical needs, low SES, and lack of social support. [source]


Predicting neurodevelopmental impairment in preterm infants by standardized neurological assessments at 6 and 12 months corrected age

ACTA PAEDIATRICA, Issue 4 2010
I Grimmer
Abstract Aim:, Neurodevelopmental impairment in very preterm infants can be reasonably diagnosed by 18,24 months corrected age, whereas the predictive value of earlier assessments is debated. We hypothesized that neurological findings at 6 and 12 months indicative of subsequent cerebral palsy predict 18,24 months' neurodevelopmental impairment. Methods:, Neurodevelopmental examinations (Griffiths scales) at 20 months of age in 561 preterm infants (birth weight <1 500 g) were compared with results of standardized neurological examinations (Early Motor Pattern Profile; EMPP) and Griffiths scales at 6 (n = 451) and 12 months (n = 496) corrected age. Results:, Griffiths developmental quotients at 20 months were weakly but significantly related to EMPP scores at 6 (Rs = 0.328) and 12 months (Rs = 0.493). Areas under receiver operator characteristic curves for the EMPP to predict neurodevelopmental impairment (Griffiths scores ,75) at 20 months were 0.772 (0.890) at 6 (12) months, compared to 0.915 (0.962) for Griffiths scores. By contrast, EMPP and Griffiths scores had equal power to predict unability to walk unaided at 2 years of age (EMPP 6/12 months: 0.946/0.983; Griffiths 6/12 months: 0.935/0.985). Conclusion:, Neurological examinations with the EMPP at 6 and 12 months corrected age are of limited value to predict neurodevelopmental impairment at 20 months. [source]


Neurodevelopmental impairment: Predictors of its impact on the families of extremely low birth weight infants at 18 months,

INFANT MENTAL HEALTH JOURNAL, Issue 6 2008
Bonnie E. Stephens
Effects on a family of a child with chronic illness have been described. The Impact on Family Scale (IOF) was developed to measure these effects. The impact of extremely low birth weight (ELBW) infants with neurodevelopmental impairment on families is unknown. This study determined IOF scores for families of ELBW infants with increasing degree of impairment at 18 months and identified factors that increase vulnerability to impact. A total of 3,849 ELBW infant survivors born at the 16 centers of the National Institute of Child Health and Human Development Neonatal Research Network between January 1993 and February 2001 were assessed at 18 to 22 months. Infants were divided into four groups by degree of impairment. IOF scores were analyzed by impairment group. Multivariate analyses assessed effects of impairment, social/demographic factors, unmet service needs, and resource utilization on the IOF. A total of 1,624 (42.2%) infants had moderate/severe impairment. Increasing severity of impairment was associated with higher IOF scores. Severity of impairment contributed 6% of variance to the IOF scores. Twenty-one percent of variance was contributed by additional medical needs, low socioeconomic status (SES), and lack of social support. Although increasing severity of impairment impacts families of ELBW infants, significantly more impact is contributed by additional medical needs, low SES, and lack of social support. [source]


Neurodevelopmental outcomes and surgery in neonates

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 12 2006
Karen Walker
Abstract: A neonate requiring major surgery in 2006 has a greater prospect of survival than ever before. Increasingly, however, there is awareness that critical illness may affect later neurodevelopment. Pre-existing conditions in addition to the physiologic stresses associated with cardiac and general surgery are implicated but remain unavoidable in the case of significant structural abnormalities such as transposition of the great arteries or congenital diaphragmatic hernia. For those affected by neurodevelopmental impairment, there is a significant cost to the child, family and society. Current research focuses on the preventable causes of brain injury, before, during and after the intervention, and the rate of impairment in apparently uncomplicated procedures. In contrast to the quantity of neurodevelopmental outcome data following cardiac surgery, there remain few outcome studies dealing with non-cardiac surgery despite such intervention being two to three times more common. There appear to be compelling clinical and economic arguments for the instigation of formalised population-based developmental assessments for all infants undergoing major surgery. [source]


Escherichia coli: a growing problem in early onset neonatal sepsis

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2004
Bronwyn JONES
Abstract Aims: To review the demographic characteristics, antecedents and outcome for early neonatal Escherichia coli sepsis. Secondary aims were to identify antenatal antibiotic use and to review the antimicrobial susceptibility. Methods: A retrospective chart review was performed for all infants with a positive culture for E. coli from either blood or CSF samples obtained between January 1998 and October 2002. Results: Nineteen liveborn infants with early onset sepsis and one stillborn baby with a positive maternal blood culture for E. coli were identified. Pregnancy complications included multiple pregnancy in five (25%), preterm rupture of membranes 10 (50%) and maternal urinary tract infection in five (25%). Eighteen of the cases were born preterm and two at term. The mortality was 8/20 (40%), and for nine cases with developmental outcome data available, 67% were within normal limits and 33% were abnormal. Of the 20 E. coli isolates 11 (55%) were resistant to amoxycillin and 1 (5%) was resistant to gentamicin. Conclusions: Infants with early onset E. coli sepsis had a poor outcome with high mortality and a third of the survivors manifesting neurodevelopmental impairment. Although amoxycillin resistance is common, there is a low prevalence of gentamicin resistance in local isolates. [source]


Influence of clinical status on the association between plasma total and unbound bilirubin and death or adverse neurodevelopmental outcomes in extremely low birth weight infants

ACTA PAEDIATRICA, Issue 5 2010
W Oh
Abstract Objectives:, To assess the influence of clinical status on the association between total plasma bilirubin and unbound bilirubin on death or adverse neurodevelopmental outcomes at 18,22 months corrected age in extremely low birth weight infants. Method:, Total plasma bilirubin and unbound bilirubin were measured in 1101 extremely low birth weight infants at 5 1 days of age. Clinical criteria were used to classify infants as clinically stable or unstable. Survivors were examined at 18,22 months corrected age by certified examiners. Outcome variables were death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss, and death prior to follow-up. For all outcomes, the interaction between bilirubin variables and clinical status was assessed in logistic regression analyses adjusted for multiple risk factors. Results:, Regardless of clinical status, an increasing level of unbound bilirubin was associated with higher rates of death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss and death before follow-up. Total plasma bilirubin values were directly associated with death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss, and death before follow-up in unstable infants, but not in stable infants. An inverse association between total plasma bilirubin and death or cerebral palsy was found in stable infants. Conclusions:, In extremely low birth weight infants, clinical status at 5 days of age affects the association between total plasma bilirubin and death or adverse neurodevelopmental outcomes at 18,22 months of corrected age. An increasing level of UB is associated a higher risk of death or adverse neurodevelopmental outcomes regardless of clinical status. Increasing levels of total plasma bilirubin are directly associated with increasing risk of death or adverse neurodevelopmental outcomes in unstable, but not in stable infants. [source]


Predicting neurodevelopmental impairment in preterm infants by standardized neurological assessments at 6 and 12 months corrected age

ACTA PAEDIATRICA, Issue 4 2010
I Grimmer
Abstract Aim:, Neurodevelopmental impairment in very preterm infants can be reasonably diagnosed by 18,24 months corrected age, whereas the predictive value of earlier assessments is debated. We hypothesized that neurological findings at 6 and 12 months indicative of subsequent cerebral palsy predict 18,24 months' neurodevelopmental impairment. Methods:, Neurodevelopmental examinations (Griffiths scales) at 20 months of age in 561 preterm infants (birth weight <1 500 g) were compared with results of standardized neurological examinations (Early Motor Pattern Profile; EMPP) and Griffiths scales at 6 (n = 451) and 12 months (n = 496) corrected age. Results:, Griffiths developmental quotients at 20 months were weakly but significantly related to EMPP scores at 6 (Rs = 0.328) and 12 months (Rs = 0.493). Areas under receiver operator characteristic curves for the EMPP to predict neurodevelopmental impairment (Griffiths scores ,75) at 20 months were 0.772 (0.890) at 6 (12) months, compared to 0.915 (0.962) for Griffiths scores. By contrast, EMPP and Griffiths scores had equal power to predict unability to walk unaided at 2 years of age (EMPP 6/12 months: 0.946/0.983; Griffiths 6/12 months: 0.935/0.985). Conclusion:, Neurological examinations with the EMPP at 6 and 12 months corrected age are of limited value to predict neurodevelopmental impairment at 20 months. [source]


Cognitive outcome at 2 years of age in Finnish infants with very low birth weight born between 2001 and 2006

ACTA PAEDIATRICA, Issue 3 2010
P Munck
Abstract Aim:, To study cognitive outcome of premature, very low birth weight (VLBW) infants in relation to parental education and neonatal data. Methods:, A regional cohort of 182 VLBW infants born between 2001 and 2006 was followed up. Brain ultrasounds (US) were examined serially until term age and brain magnetic resonance imaging at term age. Neurological status was examined systematically. Cognitive development was assessed using the Mental Developmental Index (MDI) of Bayley Scales at 2 years of corrected age. A total of 192 healthy full-term (FT) controls were assessed with the MDI at 2 years of age. Results:, The mean MDI in VLBW infants was 101.7 (SD 15.4), which was lower compared with FT controls (109.8, SD 11.7, p < 0.001). In regression analysis of the demographic and medical data of VLBW infants, postnatal corticosteroids (p = 0.04), intestinal perforation (p = 0.03) and major brain pathology (p = 0.02) were negatively associated with the MDI. In VLBW infants, the prevalence of neurodevelopmental impairment was 9.9% (3.3% MDI below 70, 7.1% cerebral palsy, 2.2% hearing aid, no blind infants). Conclusion:, Cognitive development of VLBW infants seemed to have improved in comparison with earlier publications, but it differed from the FT controls. Neonatal factors affected cognitive development. Therefore, updated regional follow-up data are important for clinicians. [source]


Impact of chorioamnionitis and preeclampsia on neurodevelopmental outcome in preterm infants below 32 weeks gestational age

ACTA PAEDIATRICA, Issue 10 2010
Luregn J Schlapbach
Abstract Aim:, Intrauterine conditions may interfere with foetal brain development. We compared the neurodevelopmental outcome between infants <32 weeks gestational age after maternal preeclampsia or chorioamnionitis and controls. Methods:, Case-control study on infants with maternal preeclampsia, chorioamnionitis and controls (each n = 33) matched for gestational age. Neurodevelopment at 2 years was assessed with the Bayley Scales of Infant Development II. Results:, A total of 99 infants were included with a median gestational age of 29 weeks (range 25,32). Median mental developmental index (MDI) was 96 in the control, 90 in the chorioamnionitis and 86 in the preeclampsia group. Preeclampsia infants had a lower MDI compared with the control group (univariate p = 0.021, multivariate p = 0.183) and with the chorioamnionitis group (univariate p = 0.242; multivariate p = 0.027). Median psychomotor index was 80.5 in the control, 80 in the preeclampsia and 85 in the chorioamnionitis group and was not different between these three groups (p > 0.05). Chorioamnionitis or preeclampsia exposure was not associated with major neurodevelopmental impairments (cerebral palsy, MDI<70, PDI<70). Conclusion:, The results of this preliminary study suggest that preeclampsia and chorioamnionitis play a relatively minor role among risk factors for adverse neurodevelopment outcome. Postnatal factors such as ventilation and bronchopulmonary dysplasia may have a greater impact on neurodevelopmental outcome. [source]