The risk for delayed development in low birth weight, appropriate for gestational age preterm infants
Keywords:
preterm, low birth weight, developmental delay, Bayley Infant Neurodevelopmental Screener
Abstract
Background Preterm infants, particularly those who have hadsevere asphyxia, hyperbilirubinemia, and sepsis, tend to be at risk
for neurodevelopmental impairment.
Objective The purpose of this study was to assess the risk for de-
layed development in low birth weight (LBW), appropriate for gesta-
tional age (AGA) preterm infants compared to that in term, non-LBW
infants, and to investigate the roles of severe asphyxia, sepsis, and
hyperbilirubinemia as potential risk factors for delayed development.
Methods This was a hospital-based retrospective cohort study
involving preterm, LBW and term, non-LBW infants conducted in
Hasan Sadikin Hospital, Bandung. The Bayley Infant
Neurodevelopmental Screener (BINS) test was performed to as-
sess the risk of delayed development at 3 months of corrected age
for the preterm infants and at 3 months of chronological age for the
term infants. Bivariate analysis using the chi-square test and mul-
tivariate analysis using logistic regression were performed.
Results One hundred and twelve infants fulfilled eligibility criteria,
consisting of 52 preterm, LBW and 60 term, non-LBW infants. Based
on the BINS test, of the preterm, LBW infants, 32 (61%) were at
low risk, 11 (21%) at moderate risk, and 9 (17%) at high risk for
delayed development. Of the control infants, 49 (82%) were at low
risk, 10 (17%) at moderate risk, and 1 (1.7%) at high risk for de-
layed development. Logistic regression analysis showed signifi-
cant association between accompanying diseases such as sepsis
(OR=25.60; P=0.001) and hyperbilirubinemia (OR=16.07; P=0.001)
with delayed development. Despite more than twofold odds for
delayed development in infants with severe asphyxia (OR=2.51)
and LBW-prematurity (OR=2.47), the association was statistically
insignificant (P=0.20 and P=0.15, respectively).
Conclusions In preterm infants appropriate for gestational age,
prematurity and low birth weight alone may or may not predispose
to delayed development at 3 months of age. However, the risk for
delayed development in such infants is increased when sepsis or
hyperbilirubinemia is present
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Pathophysiology and management of the newborn. 5 th
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In: Taeusch HW, Ballard RA, editors. Avery’s diseases
of the newborn. 7 th edition. Philadelphia: WB
Saunders; 1998. p. 413-28.
3. Allen MC. The high-risk infant. Pediatr Clin North
Am 1993;40:479-90.
4. Stoll BJ, Kliegman RM. The high-risk infant. In:
Behrman RE, Kliegman RM, Jenson HB, editors.
Nelson textbook of pediatrics. 16 th edition. Philadel-
phia: WB Saunders; 2000. p. 474-85.
5. Adhikari M. Problems of the preterm infant. In: Bassin
J, Ginsberg ND, editors. Topics in pediatrics. Johannes-
burg: Julmar Communications; 1996. p. 19-27.
6. Usman A, Alisjahbana A. Preliminary report on peri-
natal mortality and low birth weight infant in
Tanjungsari [unpublished data]. Bandung; 1988.
7. Departemen Kesehatan Republik Indonesia. Profil
Kesehatan Indonesia. Jakarta: Pusat Data Kesehatan;
1998.
8. Aylward GP, Pfeiffer SI, Wright A, Verhulst J. Outcome
studies of low birth weight infants published in the last
decade: a meta-analysis. J Pediatr 1989;115:515-20.
9. Hack M, Klein NK, Taylor HG. Long term develop-
mental outcomes of low birth weight infants. The Fu-
ture of Children 1995;5:176-96.
10. Escobar GJ, Littettnberg B, Petitti DB. Outcome among
surviving very low birth weight infants: A meta analy-
sis. Arch Dis Child 1991;66:204-11.
11. Aylward GP. Bayley infant neurodevelopmental
screener. 2 nd edition. San Antonio: The Psychological
Corporation; 1995.
12. Soetjiningsih. Tumbuh kembang anak. In: Ranuh IGN, edi-
tor. Tumbuh kembang anak. Jakarta: EGC; 1995. p. 1-32.
13. Aylward GP. The relationship between environmental
risk and development outcome. J Dev Behav Pediatr
1992;13:3-20.
14. Dunn HG, Robertson AM, Crichton JU. Clinical out-
come: Neurological sequelae and their evolution. 1 st
edition. London: Mac Keith Press; 1986. p. 68-96.
15. Lenke MC. Motor outcome in premature infants.
Cited 2003 October 1. Available from: URL: http://
www.medscape.com/viewarticle/461577.
16. Gottoff SP. Infections of the neonatal infant. In:
Behrman RE, Kliegman RM, Jenson HB, editors.
Nelson textbook of pediatrics. 16 th ed. Philadelphia:
WB Saunders Co; 2000. p. 538-51.
17. Narendra M. Penilaian pertumbuhan dan perkembangan
anak. In: Narendra M, Sularyo S, Soetjiningsih, editors.
Tumbuh kembang anak dan remaja. Jakarta: Sagung
Seto; 2002. p. 95-111.
Published
2016-10-10
How to Cite
1.
Peryoga S, Sukadi A, Wiradisuria S. The risk for delayed development in low birth weight, appropriate for gestational age preterm infants. PI [Internet]. 10Oct.2016 [cited 23Dec.2024];45(4):154-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/828
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Received 2016-10-08
Accepted 2016-10-08
Published 2016-10-10
Accepted 2016-10-08
Published 2016-10-10
