Factors affecting neurodevelopmental outcome at 2 years in very preterm infants below 1250 grams: a prospective study

Objectiveto evaluate the neurodevelopmental outcomes of preterm very-low birth weight (pt/vlbw) infants at 2 years and identify risk factors associated with significant developmental delay or neurodevelopmental impairment (ndi).study designwe evaluated 165 pt/vlbw infants born between january 2010 and december 2011, using the bayley scales of infant and toddler development 3rd edition (bayley-iii). ndi was defined as the presence of neurosensory impairment or significant delay with bayley-iii score < 70 in any domain and risk factors for delay/ndi were assessed using logistic regressions.resultsmedian bayley-iii composite scores in the cognitive, language and motor domains were 95, 89 and 94, respectively. ndi was present in 20% of the children, with 5–18% having significant delay in either cognitive, language or motor domain, seven (4%) children had cerebral palsy, three (2%) were deaf and none were blind. regression models identified significant positive associations of delayed cognitive skills with male gender (odds ratio (or) 22.4, 95% confidence interval (ci) 1.5–341.1; p = 0.025), lack of anntenatal steroids (ans) (or 41.5, 95% ci 3.5–485.7; p = 0.003), and hypotension needing inotropes (or 36.0, 95% ci 2.6–506.0; p = 0.008); delayed language skills with lower maternal education (or 3.8, 95% ci 1.4–10.3; p = 0.10), lack of ans (or 2.8, 95% ci 1.1–7.4; p = 0.04), and 5 minute apgar score ≤ 5 (or 7.4, 95% ci 1.4–38.4; p = 0.017) and delayed motor skills with chronic lung disease at 36 weeks (or 38.3, 95% ci 2.4–603.4; p = 0.010). ndi was associated with lack of ans (or 2.91, 95% ci 1.21–7.00; p = 0.02) and use of postnatal steroids (or 3.36, 95% ci 1.07–10.54; p = 0.0374).conclusionrisk factors for both ndi and individual domain delay were identified and will be helpful in planning of specific and targeted early intervention services.