Factors associated with adverse neurodevelopment outcome using Bayley III scale at 3 to 6 month follow-up

Abstract

Introduction: As the survival rate of preterm infants has increased, the management of long-term complications, especially neurodevelopmental impairment, becomes important. Several studies have suggested that adverse neurodevelopment could be induced by systemic inflammation in preterm infants. Preterm infants with systemic inflammation would have impaired neurodevelopment and which biomarkers and neurophysiologic studies during inflammation are associated with poor neurodevelopment. Objective: To assess the factors associated with adverse neurodevelopment outcome using bayley iii scale at 3 to 6 month follow-up. Materials and methods: This prospective cohort study was conducted in Department of Paediatrics, Mugda Medical College Hospital, Dhaka, Bangladesh from July 2021 to December 2021. After taking informed written consent (annexure-III) from parents of the selected premature infants to participate in the study, a total of 82 neonates were enrolled. Hospitalized inborn and out born babies were included consecutively. Results: A total 54 patients were analyzed in 1st follow up visit by using Bayley scale III. Mean cognitive score were 81.67±7.58 and 73.50±10.16 in ACS exposed and ACS unexposed group (p-0.001).Mean language score were 85.33±6.73 vs. 77.88±9.98, (p- 0.002). Mean motor score were 84.50±9.83 vs. 76.83±12.03 in ACS exposed and ACS unexposed group (p- 0.013). Though all scores were below normal in both groups, ACS exposed group had relatively better score than ACS unexposed group at 3 months of age. During 2nd follow up 47 infants were assessed at 6 months of age, mean cognitive score in ACS group was 84.88±12.32 and in ACS unexposed group was 75.71±15.67.which was statistically significant(p- .030).Motor and language composite scores were higher at 6 months in ACS group but no difference between two groups were statistically significant. Conclusion: Our prospective cohort study showed that systemic inflammation induced by clinical infection and NEC is associated with poor neurodevelopment in preterm infants. These results may help estimate the neurodevelopmental risk of individual patients who have inflammatory illness and narrow down the target population of neuroprotection in the future.