Department of Neonatology, Institute of Post Graduate Medical Education & Research, 244, A J C Bose Road, Kolkata, 700020, India.
Eur J Pediatr. 2023 Jun;182(6):2715-2722. doi: 10.1007/s00431-023-04953-x. Epub 2023 Apr 1.
The late preterm infants (34 0/7 to 36 6/7 weeks of gestation) account for at least 70% of all preterm birth. Our aim was to detect growth and neurodevelopment outcome, incidence of neurodevelopmental disability, and its association with maternal and neonatal risk factors among sick late preterm population. Two hundred and ninety-nine late preterm infants were followed up till corrected 2 years of age in this retrospective cohort study. Assessment was done by anthropometry and Developmental Assessment Scale for Indian Infants (DASII) scale at corrected 2 years of age. Presence of visual and hearing impairment, cerebral palsy, and overall neurodevelopmental impairment were also recorded. At 2 years of corrected age, average motor development quotient (DMoQ) was 93.55 (95% CI 90.9 to 96.20) and average mental development quotient (DMeQ) was 89.59 (95% CI 87.13 to 92.04). The incidence of bilateral severe to profound hearing loss and visual loss were found in 6 (2%) and 4 (1.33%) infants, respectively. Severe neurodevelopmental impairment was found in 19 (6.35%) infants. Central nervous system disease and sepsis were found as independent predictors of moderate to severe neurodevelopmental disability. Conclusion: Late preterm infants admitted in neonatal units were at risk of growth and neurodevelopmental impairment requiring close neurodevelopmental follow-up. In a resource limited setting, this may best be achieved by using DASII in follow-up clinic. What is Known: • Late preterm infants are at a high risk of prematurity-related morbidities. • There is increased risk of cognitive defect, learning difficulties, and behavior problems found at school age for sick late preterm infants. What is New: • Central nervous system disease and sepsis were found as independent predictors of early moderate to severe neurodevelopmental impairment for sick late preterm infants in developing countries like India.
晚期早产儿（340/7 至 366/7 周妊娠）占所有早产儿的至少 70%。我们的目的是检测患病晚期早产儿的生长和神经发育结局、神经发育障碍的发生率及其与母婴危险因素的关系。在这项回顾性队列研究中，对 299 名晚期早产儿进行了随访，直至校正 2 岁。在校正 2 岁时，通过体格测量和印度婴儿发育评估量表（DASII）进行评估。还记录了视力和听力障碍、脑瘫和整体神经发育障碍的存在情况。在校正 2 岁时，平均运动发育商（DMoQ）为 93.55（95%置信区间 90.9 至 96.20），平均精神发育商（DMeQ）为 89.59（95%置信区间 87.13 至 92.04）。双侧严重至深度听力损失和视力丧失的发生率分别为 6（2%）和 4（1.33%）。19 名（6.35%）婴儿被发现有严重的神经发育障碍。中枢神经系统疾病和败血症被认为是中重度神经发育障碍的独立预测因素。结论：入住新生儿病房的晚期早产儿有生长和神经发育受损的风险，需要密切进行神经发育随访。在资源有限的环境中，最好在随访诊所使用 DASII 来实现这一目标。已知情况：•晚期早产儿发生与早产相关的发病率和死亡率的风险较高。•患有疾病的晚期早产儿在发展中国家（如印度），在学龄期有认知缺陷、学习困难和行为问题的风险增加。新情况：•中枢神经系统疾病和败血症是导致发展中国家（如印度）患病晚期早产儿早期中重度神经发育障碍的独立预测因素。
