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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.

Author information

1
Neonatal Intensive Care Unit, Children's Hospital 1, Ho Chi Minh City, Vietnam.
2
Global Health Unit, Department of Paediatric and Adolescence, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
3
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
4
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
5
Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

Abstract

BACKGROUND:

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

OBJECTIVES:

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.

DESIGN AND SETTING:

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

PARTICIPANTS:

Infants born at <37 weeks of gestational age.

MAIN OUTCOMES:

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

RESULTS:

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).

CONCLUSIONS:

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.

KEYWORDS:

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

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