LONG TERM NEURODEVELOPMENTAL OUTCOME IN A COHORT OF PRETERM INFANTS BORN AT GESTATIONAL AGE <32 WEEKS

摘要

Advances in perinatal care have led to an increase in survival of preterm children but have also increased the risk of long-term sequelae, like neurodevelopmental impairment and behavioral or emotional disturbance. To investigate neurodevelopmental patterns of preterm infants born at S. Maria alle Scotte Hospital, Siena, Italy. 128 babies with gestational age (GA) ≤32 weeks were admitted in 2006-2008 to Siena Hospital; 105 infants survived and were followed until three years of age, corrected for prematurity. Neurodevelopmental follow up was performed using Bayley scale of Infant and Toddler Development IIIed that consisted of five scales: Cognitive (CS), Language (LS), Motor (MS), Social-Emotional (SES) and Adaptive Behavior Scale (ABS). Intraventricular haemorrhage (IVH) was associated with lower motor score (P<0,001). Babies with retinopathy of prematurity (ROP) showed a lower score in CS, LS, MS and SES Bayley’s items (respectively p≤0,01; p≤0,05; p≤0,01; p≤0,05). Multiple regression analysis indicated as predictors of neurological outcome: gestational age (GA) for poor cognitive (p=0,016), language (p=0,004) and social-emotional development (p<0,0001), IVH for poor motor (p<0,0001) and adaptive behavior development (p<0,0001), twinship for better language (p=0,001) and social-emotional development (p=0,003). Bronchopulmoanry dyspasia (BPD) and patent ductus arteriosus (PDA) had a negative effect on respectively cognitive development (p=0,049) and social-emotional development (p=0,023). ROP, BPD, IVH, PDA, and GA significantly contributes to poor neurological outcome in preterm infants. BPD and IVH are the best predictors being associated with the lowest scores at Bayley scales. Surprisingly, twinship appeared to be a protective factor.