Neonatal Med.  2022 Feb;29(1):36-45. 10.5385/nm.2022.29.1.36.

Neurodevelopmental Outcomes of Very-Low-Birth-Weight Infants without Severe Brain Lesions and Impact of Postnatal Steroid Use: A Single-Center Korean Study

• Jeong MH
• Jeong SH
• Park SJ
• Lee N
• Bae MH
• Park KH
• Byun SY
• Kim C
• Han YM

• KMID: 2527259
• DOI: http://doi.org/10.5385/nm.2022.29.1.36

Abstract

Purpose
We used the Bayley Scales of Infant and Toddler Development (BSID)-III to analyze the incidence and risk factors of developmental delay in very-low-birth-weight infants without severe brain lesions. We further examined the correlation between the cumulative dexamethasone dose and developmental assessment results.
Methods
We retrospectively analyzed data of preterm infants (birth weight <1,500 g) admitted to our neonatal intensive care unit between January 2014 to December 2020. The BSID-III scores obtained between the corrected ages of 12 and 24 months and after 24 months were analyzed. Developmental delay was defined as a composite score of <85 for the cognition, language, and motor domains. Univariate and multivariate analyses of developmental delay risk factors and developmental changes from the first to second BSID-III were performed. Correlations between the accumulated dexamethasone dose used for bronchopulmonary dysplasia (BPD) and the first and second test scores were analyzed.
Results
Seventy-one and thirty-six infants completed the first and second tests, respectively. In both tests, developmental delay was most commonly observed in the language domain (26.8%, 47.2%). In multivariate analysis, mild BPD was identified as a developmental delay risk factor (P<0.05), whereas prenatal steroid use reduced the developmental delay risk (P<0.05). All domain scores were lower in the second test than in the first test. The cognition and language domain scores in the second test decreased with increasing cumulative dexamethasone doses.
Conclusion
Very-low-birth-weight infants typically experience language delay, which can persist as they age.

Keyword

Infant, very low birth weight; Developmental disabilities; Dexamethasone

Figure

• 

  Figure 1. Enrollment of the study group. Abbreviations: VLBW, very low birth weight; BSID, Bayley Scales of Infant and Toddler Development; K-DDST, Korean Denver Developmental Screening Test; IVH, intraventricular hemorrhage; PVL, periventricular leukomalacia.

• 

  Figure 2. Simple linear regression for the results of the Bayley Scales of Infants and Toddler Development within and after 'the' corrected 'age' of 24 months according to the development domain. (A) Cognition domain, (B) language domain, (C) motor domain, (D) mean composite score of three domains.

• 

  Figure 3. Scatter plots and Pearson correlation coefficients (r) between the total accumulated dose of dexamethasone and composite score by development domains after the corrected age of 24 months. (A) Cognition domain, (B) language domain, (C) motor domain.

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