Enhancing the Follow-up Assessment of Very Preterm Children with Regard to 5-Year IQ Considering Socioeconomic Status.
Options
Date of Publication
December 2022
Publication Type
Article
Division/Institute
Author
Hoberg, Kathrin | |
Häusler, Martin | |
Orlikowsky, Thorsten |
Subject(s)
Series
Zeitschrift für Geburtshilfe und Neonatologie
ISSN or ISBN (if monograph)
0948-2393
Publisher
Thieme
Language
English
Publisher DOI
PubMed ID
35981549
Description
BACKGROUND
Specifying peri- and postnatal factors in children born very preterm (VPT) that affect later outcome helps to improve long-term treatment.
AIM
To enhance the predictability of 5-year cognitive outcome by perinatal, 2-year developmental and socio-economic data.
SUBJECTS AND OUTCOME MEASURES
92 VPT infants, born 2007-2009, gestational age<32 weeks and/or birthweight of 1500 g, were assessed longitudinally including basic neonatal, socio-economic (SES), 2-year Mental Developmental Index (MDI, Bayley Scales II), 5-year Mental Processing Composite (MPC, Kaufman-Assessment Battery for Children), and Language Screening for Preschoolers data. 5-year infants born VPT were compared to 34 term controls.
RESULTS
The IQ of 5-year infants born VPT was 10 points lower than that of term controls and influenced independently by preterm birth and SES. MDI, SES, birth weight and birth complications explained 48% of the variance of the MPC. The MDI proved highly predictive (r=0.6, R2=36%) for MPC but tended to underestimate the cognitive outcome. A total of 61% of the 2-year infants born VPT were already correctly classified (specificity of .93, sensitivity of .54). CHAID decision tree technique identified SES as decisive for the outcome for infants born VPT with medium MDI results (76-91): They benefit from effects associated to a higher SES, while those with a poor MDI outcome and a birth weight≤890 g do not.
CONCLUSION
Developmental follow-up of preterm children enhances the quality of prognosis and later outcome when differentially considering perinatal risks and SES.
Specifying peri- and postnatal factors in children born very preterm (VPT) that affect later outcome helps to improve long-term treatment.
AIM
To enhance the predictability of 5-year cognitive outcome by perinatal, 2-year developmental and socio-economic data.
SUBJECTS AND OUTCOME MEASURES
92 VPT infants, born 2007-2009, gestational age<32 weeks and/or birthweight of 1500 g, were assessed longitudinally including basic neonatal, socio-economic (SES), 2-year Mental Developmental Index (MDI, Bayley Scales II), 5-year Mental Processing Composite (MPC, Kaufman-Assessment Battery for Children), and Language Screening for Preschoolers data. 5-year infants born VPT were compared to 34 term controls.
RESULTS
The IQ of 5-year infants born VPT was 10 points lower than that of term controls and influenced independently by preterm birth and SES. MDI, SES, birth weight and birth complications explained 48% of the variance of the MPC. The MDI proved highly predictive (r=0.6, R2=36%) for MPC but tended to underestimate the cognitive outcome. A total of 61% of the 2-year infants born VPT were already correctly classified (specificity of .93, sensitivity of .54). CHAID decision tree technique identified SES as decisive for the outcome for infants born VPT with medium MDI results (76-91): They benefit from effects associated to a higher SES, while those with a poor MDI outcome and a birth weight≤890 g do not.
CONCLUSION
Developmental follow-up of preterm children enhances the quality of prognosis and later outcome when differentially considering perinatal risks and SES.