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Arch Dis Child. 2020 Feb;105(2):134-140. doi: 10.1136/archdischild-2019-316967. Epub 2019 Jul 12.

Neurodevelopment at 2 years corrected age among Vietnamese preterm infants.

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Neonatal Intensive Care Unit, Children's Hospital 1, Ho Chi Minh City, Vietnam.
Global Health Unit, Department of Paediatric and Adolescence, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.



Preterm infants are at risk of neurodevelopmental delay, but data on long-term outcomes in low-income and middle-income countries remain scarce.


To examine neurodevelopment using Bayley Scales of Infant and Toddler Development-3rd edition (Bayley-III) and neurological findings in 2-year-old preterm infants, and to compare with healthy Vietnamese infants. Further, to assess factors associated with neurodevelopmental impairment.


Cohort study to follow up preterm infants discharged from a neonatal intensive care unit (NICU) of a tertiary children's hospital in Vietnam.


Infants born at <37 weeks of gestational age.


Bayley-III assessment and neurological examination at 2-year corrected age (CA) compared with healthy Vietnamese infants.


Of 294 NICU preterm infants, Bayley-III scores of all 184/243 (76%) survivors at 2 years CA were significantly lower than those of healthy Vietnamese peers in all three domains: cognition (mean (SD): 84.5 (8.6) vs 91.4 (7.5), p<0.001), language (mean (SD): 88.7 (12.5) vs 95.9 (11.9), p<0.001) and motor (mean (SD): 93.1 (9.0) vs 96.8 (9.3), p=0.003). The mean differences in Bayley-III scores between preterm and healthy Vietnamese infants were -6.9 (-9.1 to -4.7), -7.2 (-10.5 to -3.8) and -3.7 (-6.1 to -1.2) for cognitive, language and motor scores, respectively. The prevalence of neurodevelopmental impairment was 17% for cognitive, 8% for language and 4% for motor performance. In total, 7% were diagnosed with cerebral palsy. Higher maternal education was positively associated with infant neurodevelopment (OR 0.32, 95% CI 0.11 to 0.94).


Vietnamese preterm infants in need of neonatal intensive care showed poor neurodevelopment at 2 years. Higher maternal education was positively associated with infant neurodevelopment. Standard follow-up programmes for preterm infants should be considered in low-resource settings.


Bayley scale; intensive care; low resource setting; middle-income country; neurodevelopment; preterm infant

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