Neurodevelopmental Outcomes of Very Low Birth Weight Preterm Infants in the Regional Pediatric Clinic

Ivana Jurić*; Silvija Pušeljić

doi:10.26332/seemedj.v7i2.285

Ivana Jurić* Clinical Hospital Center Osijek, Emergency Hospital Admission Department, Osijek, Croatia
Silvija Pušeljić University Hospital Center Osijek, Department of Pediatrics, Division of neurology, genetic, metabolic disease, and endocrinology, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia

DOI: https://doi.org/10.26332/seemedj.v7i2.285

Abstract

Aim: To examine the incidence and etiology of neurodevelopmental outcomes in very low birth weight preterm infants, maternal and perinatal risk factors, comorbidities, and clinical presentation and compare with newborns of the same gestational age who did not develop a neurodevelopmental disorder.

Methods: The research was conducted at the Pediatric Clinic in KBC (Clinical Hospital Center) Osijek. All newborns born from 1 January 2018 to 31 December 2019 with birth weight < 1,500 g and gestational age < 37 weeks are included in the research. The data were collected by reviewing medical records and the hospital’s IT system.

Results: In the observed period, 120 children with birth weight < 1,500 g and gestational age < 37 weeks were born. Maternal and perinatal risk factors for premature birth include autoimmune diseases of the mother, infections during pregnancy and birth complications. Early complications that accompany the selected group are RDS, ROP, NEC, IVH, sepsis, congenital heart defects and glucose metabolism disorder. Slowed motor, cognitive and speech development are mostly influenced by low body weight, higher degree of IVH, lower AS in the first minute and the presence of NEC. Significant risk factors for death are gestational age < 25 weeks, body weight < 800 g, infections in pregnancy and autoimmune diseases of the mother.

Conclusion: The neurodevelopmental outcome of very low birth weight preterm infants depends on a combination of comorbidities, as well as maternal, perinatal and neonatal risk factors.

Sažetak

Cilj: Ispitati učestalost i etiologiju neuroloških ishoda u nedonoščadi s vrlo niskom porođajnom težinom, čimbenike rizika kod majke i tijekom perinatalnog perioda, komorbiditete i kliničku sliku i usporediti s novorođenčadi iste gestacijske dobi koja nisu razvila neurološki poremećaj.

Metode: Istraživanje je provedeno na Klinici za pedijatriju KBC-a Osijek. U istraživanje su uključena sva novorođenčad rođena u razdoblju od 1. 1. 2018. do 31. 12. 2019. godine s porođajnom težinom manjom od 1 500 g i gestacijskom dobi kraćom od 37 tjedana. Podaci su prikupljeni pregledom medicinske dokumentacije i bolničkoga informatičkog sustava.

Rezultati: U promatranom razdoblju rođeno je 120 djece s porođajnom težinom manjom od 1 500 g i gestacijskom dobi kraćom od 37 tjedana. Čimbenici rizika za prijevremeni porod kod majki i tijekom perinatalnog perioda uključuju autoimune bolesti majke, infekcije tijekom trudnoće i komplikacije pri porodu. Rane komplikacije koje prate odabranu skupinu su RDS, ROP, NEC, IVH, sepsa, kongenitalne srčane mane i poremećaj metabolizma glukoze. Usporeni motorički, kognitivni i govorni razvoj najviše su pod utjecajem male porođajne težine, višeg stupnja IVH-a, nižeg apgar indeksa u prvoj minuti i prisutnosti NEC-a. Značajni čimbenici rizika za smrt su gestacijska dob manja od 25 tjedana, porođajna težina manja od 800 g, infekcije u trudnoći i autoimune bolesti majke.

Zaključak: Neurološki ishod nedonoščadi s vrlo malom porođajnom težinom ovisi o kombinaciji komorbiditeta, majčinskih, perinatalnih i neonatalnih čimbenika rizika.