Developmental outcome of very-low-birth-weight infants born in 2013-2015 without major brain injury based on data from the Korean Neonatal Network : A national wide cohort study

Abstract

ABSTRACT

Developmental outcome of very-low-birth-weight infants born in 2013-2015 without major brain injury based on data from the Korean Neonatal Network : A national wide cohort study

Jong Ho CHA Department of Pediatrics The Graduate School Hanyang University

Background As preterm infants have shown advances in survival rate, many very-low-birth-weight (VLBW) infants have shown developmental delay even without a major brain injury. Thus, incidence of and risk factors associated with poor neurodevelopmental outcome should be evaluated.

Methods A multicenter nationalwide prospective longitudinal cohort study of VLBW infants born in South Korea between 2013 and 2015 was conducted. Adverse neurodevelopmental outcome was assessed using the Bayley Scales of Infant and Toddler Development III in corrected age of 18 to 24 months. Multilevel multivariate logistic regression analysis was used to analyze the odds ratio for poor neurodevelopmental outcome.

Results The study included 285 infants, of whom 34 (11.9%) exhibited cognition delay; 59 (20.7%) language delay; and 32 (11.2%), motor delay. The mean gestational age was 29 weeks, and the mean birth weight was 1130 g. Bronchopulmonary dysplasia (BPD) moderate and severe (p=0.056), intraventricular hemorrhage(IVH) grade I (p=0.079) was marginally associated with cognition delay. Higher paternal educational level (p<0.05) was significantly related with the language outcome. Birth weight(p<0.05), head circumference at discharge (p<0.05) were the major predictors of motor delay.

Conclusions This population-based nationwide cohort study shows that approximately 20% of VLBW infants with no major brain damage have developmental delay. Developmental delay was predicted by birth weight, head circumference at discharge, BPD and IVH grade I and paternal educational level. We emphasize clinicians should be aware of the risk factors for the adverse neurodevelopmental outcome even VLBW without brain injury. Keywords: Preterm; Developmental delay; Language delay; Bayley Scales of Infant and Toddler Development; Very-low-birth-weight-infants; NICU