

Published at Wednesday, March 27, 2019 12:33 PM on the BrainRepair UG organization's page
Growth variables and brain damage at birth predict developmental disability at four years of age
Growth variables and brain damage at birth predict developmental disability at four years of age
Arne JENSEN, MD, Gerhard NEUHÄUSER, MD, and Kai-Ole JENSEN, MD
Abstract
Background: Infantile brain damage and dysfunction are prime risk factors for developmental delay and Cerebral palsy in childhood that may affect school performance and educational success. Prediction of developmental performance would improve current preschool support strategies.
Objective: To explore both the effects of perinatal brain damage on psychomotor development (PMD) and the predictive capacity of birth variables on poor performance at four years of preschool age.
Methods: At 4.3(SD0.8) years, we examined the PMD of 137 newborns (61 preterm, 28-37 weeks gestation (WG) and 76 term-born infants, 38-43 WG) that were screened prospectively for Peri-/intraventricular hemorrhage (PIVH) grade 1-4 and White matter damage (WMD) using cranial ultrasound at 1-30 days after birth. We compared the results of 72 newborns with PIVH to 65 controls (no PIVH) in a matched-pair design, employing parametric and non-parametric statistical procedures, Odds ratios, and ROC curves. Relevant predictors for psychomotor performance based on IQ test (IQ), Maze test (MT), and Neurologic examination optimality score (NOS) were determined by stepwise linear regression to generate a Total Psychomotor development score (TPMDS), Morphometric vitality index (MVI), and Developmental disability index (DDI).
Results: Perinatal PIVH negatively affected MT(p<0.003) and NOS(p<0.001) but not IQ while WMD did so in all three domains of PMD. There was a decrease in TPMDS with increasing degree of PIVH(0-4) as compared with term-born controls (p<0.001). Growth retardation as assessed by Brain-body-weight and Weight/length ratios revealed a pattern of PMD that was unrelated to brain damage, reducing IQ while MT and NOS were unaffected. Preterm birth reduced all three PMD domains. TPMDS(p<0.001), MVI(p<0.001), and DDI(p<0.001) had a clear predictive capacity for PMD performance at four years age.
Conclusion: The proposed indices TPMDS, MVI, and DDI predict PMD at preschool age and allow for individualized support of children to improve school performance and educational success.