Impact of Cumulative Biomedical Risk on the Cognitive Development of Infants Born Preterm

• In Event: Poster Session 05
  In Poster Session: PS 05 Topic - Cognitive Processes

Abstract

Prematurity, associated with neonatal clinical conditions, such as septicemia, bronchopulmonary dysplasia, and intracranial hemorrhage, increased the risk for behavior problems in children born preterm (Cassiano, Gaspardo, & Linhares, 2016). Recently, a meta-analysis study found that children born preterm with very low birth weight had significantly worse performance in tests of intelligence, executive function, and information processing speed, compared to children born at term (Brydges, Landes, Reid, Campbell, French, & Anderson, 2018). The aim of the present study was to exam neonatal characteristics and the cumulative biomedical risk of infants born preterm and their associations with cognitive development at the age of 18-24 months. The sample consisted of 43 infants born preterm who underwent admission to the Neonatal Intensive Care Unit. The cumulative biomedical risk index of infants was calculated by adding one point for each of the following indicators: gestational age <28 weeks, birth weight <1,000 grams, Clinical Risk Index for Babies (CRIB) ≥ 4, anoxia, respiratory distress, recurrent apnea, acute respiratory failure, pulmonary hypertension, pneumothorax, hyaline membrane disease, bronchopulmonary dysplasia, seizure, periventricular hemorrhage, leukomalacia, necrotizing enterocolitis, septicemia, hyperbilirubinemia and retinopathy of prematurity. The total cumulative biomedical risk index resulted from the sum of the baby index and the cumulative risk related to maternal gestational health, adding one point for each of the following indicators: gestational hypertension, eclampsia, hypothyroidism and gestational diabetes (Wade, Madigan, Akbari, & Jenkins, 2015). The presence of the association between neonatal characteristics, length of hospital stay and cumulative biomedical risk index and the cognitive development of infants, assessed by the III Bayley Scales of Infant Development (Bayley, 2006), at the 18-24 month corrected age (Pearson's correlation test) was performed. The comparison between different groups was also performed by the classification of cognitive development (independent t-test). The significance level was p ≤ 0.05. It was found that only 9% of the sample had difficulty with cognitive performance. There was a significant positive correlation between gestational age and cognitive performance, and a negative correlation between this outcome and the CRIB index and length of hospital stay. Infants with a lower classification in cognitive development, when compared to those of medium or higher classification, had significantly lower gestational age, more extended hospital stay, higher neonatal clinical risk, and a higher score of the cumulative and total biomedical risk indexes. Infants with poorer cognitive performance had a higher cumulative biomedical risk, warning of the greater need for attention to this group in follow-up programs for premature infants.

Authors

• Claudia Maria Gaspardo, University of Sao Paulo
  Presenting Author

• Sarah Lima Ribeiro, University of São Paulo
  Non-Presenting Author

• Renata Freitas Martins Zorzenon
  Non-Presenting Author

• Maria Beatriz Martins Linhares, Universidade de São Paulo (USP)
  Non-Presenting Author