Motor and psycho-preverbal development of extremely preterm infants who were suffering in congenital pneumonia and early neonatal sepsis in the first 12 months of corrected age

Abstract

The information regarding the frequency and severity of Long-term neurological outcomes in preterm infants suffering from congenital pneumonia and early neonatal sepsis was Limited in the international Literature. Therefore, it will be necessary for the further study.

Aim of the study - the assessment of the frequency rate of a motor, psycho-preverbal development and neurological outcomes in preterm infants that were born with extremely low birth weight (ELBW) and very low birth weight (VLBW) and undergoing congenital pneumonia, and early neonatal sepsis, at the age of 3rd, 6th and 12th months of corrected age.

Material and methods. 80 children were included in the study. They were born with VLBW and ELBW and gestational age (GA) up to 32 weeks in V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthcare of the Russian Federation. The examination performed at 3rd, 6th, and 12th months of corrected age. Children were divided into 2 groups: 1st group - congenital bacterial infection (n=35): 1A subgroup - early neonatal sepsis (n=13), 1B subgroup - congenital pneumonia (n=22); 2nd group -respiratory distress syndrome (RDS) with the no signs of congenital infection (n=45).

Results and discussion. There were statistic significant (p<0.05) increasing of muscle tone disorders in the structure of perinatal central nervous system lesions in the 1st group of children compared to the 2nd group at the 3rd, 6th and 12th months of corrected age. The examination with Griffiths scale on 3rd months of corrected age did not present statistically significant differences between the groups. Probably, these findings were determined by non-specific indicators of psycho-preverbal development at this age. At 6th and 12th months of corrected age, the children of subgroup 1A had a statistically significant delay in psychomotor development relative to the corrected age. While the development of kids in subgroups 1B and 2 groups were often normal (p<0.05). Porencephaly was detected more frequently on 3rd, 6th, and 12th months of corrected age in children of subgroup 1A (p<0.05) by ultrasound (US). The children of subgroup 1A presented ventriculomegaly, porencephaly, and periventricular gliosis by MRI-study compared with 2nd group (p<0.05). The incidence of cerebral palsy (CP) was 11.25% in all groups of children with VLBW and ELBW. Early neonatal sepsis increased risk of the development of CP up to 30.8%.

Thus, children with congenital infection, and especially those who have suffered from early neonatal sepsis, constitute a high-risk group for the development of neurological disorders and CP.

Keywords:cerebral palsy, assessment of neurological status, premature infants, children with very low and extremely low birth weight, congenital pneumonia, early neonatal sepsis

For citation: Degtyareva A.V., Mikhaylova O.V., Amirkhanova D.Yu., Nikitina I.V., Ushakova L.V., Kirtbaya A.R., Degtyarev D.N. Motor and psycho-preverbal development of extremely preterm infants who were suffering in congenital pneumonia and early neonatal sepsis in the first 12 months of corrected age. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2019; 7 (4): 18-26. doi: 10.24411/2308-2402-2019-14002 (in Russian)

References

1. Vogel J., Chawanpaiboon S., Moller A., et al. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol. 2018; 52: 3-12.

2. Goldenberg R., Culhane J., lams J., Romero R. Epidemiology and causes of preterm birth. Lancet. 2008; 371: 75-84.

3. Glass H., Costarino A., Stayer S., et al. Outcomes for extremely premature infants. Anesth Analg. 2015; 120 (6): 1337-51.

4. Bezzine A., Chebbi I., Ben H., Marrakchi Z. In-hospital mortality of very preterm infants in a Tunisian neonatal intensive care unit: prevalence and risk factors. Tunis Med. 2018; 96 (12): 884-7.

5. Zavadenko N.N., Efimov M.S., Zavadenko A.N., et al. Disorders of neuro-mental development in premature infants with low and extremely low birth weight. Pediatriya. Zhurnal im. G.N. Speranskogo [Pediatrics. Journal named after G.N. Speranskiy]. 2015; 5 (94): 142-8. (in Russian)

6. Shalina R.I., Vyhristyuk Yu.V., Karaganov E.Ya., et al. Health of children born with extremely low and very low body weight. Lechebnoe delo [Medical Care]. 2016; 2: 14-21. (in Russian)

7. Himpens E., Van den Broeck C., Oostra A., Calders P., et al. Prevalence, type, distribution, and severity of cerebral palsy in relation to gestational age: a meta-analytic review. Dev Med Child Neurol. 2008; 50 (5): 334-40.

8. Jarjour I.T. Neurodevelopmental outcome after extreme prematurity: a review of the literature. Pediatr Neurol. 2015; 52: 143-152.

9. Pal’chik A.B., Fedorova L.A., Ponyatishin A.E. Neurology of Premature Infants. Moscow: MEDpress-inform, 2014: 376 p. (in Russian)

10. Bolisetty S., Dhawan A., Abdel-Latif M., et al. New South Wales and Australian capital territory neonatal intensive care units’ data collection intraventricular hemorrhage and neurodevelopmental outcomes in extreme preterm infants. Pediatrics. 2014; 133: 55-62.

11. Eric Z., Konjevic S. Proinflammatory cytokines in a newborn: a literature review. Signa Vitae. 2017; 13 (4): 10-3.

12. Nikitina I.V., Zhukova A.S., Van’ko L.V., et al. Features of cytokine status in premature infants with lung diseases of infectious and non-infectious genesis. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2018; (4): 16-23. (in Russian)

13. Malaeb S., Dammann O. Fetal inflammatory response and brain injury in the preterm newborn. J Child Neurol. 2009; 24 (9): 1119-26.

14. Szpecht D., Wiak K., Braszak A., et al. Role of selected cytokines in the etiopathogenesis of intraventricular hemorrhage in preterm newborns. Childs Nerv Syst. 2016; 32 (11): 2097-103.

15. Eisenhut M. Vasospasm in cerebral inflammation. Int J Inflamm. 2014; 2014: 509707.

16. Ellison V., Mocatta T., Winterbourn C., et al. The relationship of CSF and plasma cytokine levels to cerebral white matter injury in the premature newborn. Pediatr Res. 2005; 57: 282-6.

17. Basu S., Agarwal P., Anupurba S., et al. Elevated plasma and cerebrospinal fluid interleukin-1 beta and tumor necrosis factor-alpha concentration and combined outcome of death or abnormal neuroimaging in preterm neonates with early-onset clinical sepsis. J Perinatol. 2015; 35: 855-61.

18. Ionov O.V., Nikitina I.V., Zubkov V.V., Mitrokhin S.D., et al. The order of examination of newborns with suspected infectious pathology and the rules of appointment of antibacterial therapy, taken to the intensive care unit and neonatal intensive care "Scientific center for obstetrics, gynecology and perinatology acad. V.I. Kulakova" Ministry of health of Russia. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2014; 1 (3): 95-106. (in Russian)

19. Neonatology: Clinical guidelines. Edited by: N.N. Volodin, D.N. De-gtyaryev, D.S. Kryuchko. Moscow: GEOTAR-Media, 2019: 320 p. (in Russian)

20. Who.int [Electronic Resource]. WHO Child Growth Standards. Growth Reference 0-60 months. 2006. URL: http://www.who.int/childgrowth/standards/en/

21. Rezaie P., Dean A. Periventricular leukomalacia, inflammation and white matter lesions within the developing nervous system. Neuropathology. 2002; 22: 106.

22. Polin R. Systemic infection and brain injury in the preterm infant. J Pediatr (Rio J). 2008; 84 (3): 188-91.

23. Marro P The etiology and pharmacologic approach to hypoxic-ischemic encephalopathy in the newborn. Neoreviews. 2002; 3 (6): 99-107.

24. Pal’chik A.B., Fyedorova L.A. Periventricular Leukomalacia in Newborn Children. Guidelines of the Ministry of health. Saint Petersburg: SPbPMA, 2005: 46 p. (in Russian)

25. Klitochenko G.V., Tonkonozhenko N.L., Krivonozhkina P.S., Maliu-zhinskaia N.V. Clinic and diagnosis of cerebral palsy. Lekarstvennyy vestnik [Medicinal Bulletin]. 2015; 1 (57): 21-5. (in Russian)

26. Shah D., Doyle L., Anderson P., et al. Adverse neurodevelopment in preterm infants with postnatal sepsis or necrotizing enterocolitis is mediated by white matter abnormalities on magnetic resonance imaging at term. J Pediatr. 2008; 153 (2): 170-5.

27. Schlapbach L., Aebischer M., Adams M., et al. Impact of sepsis on neurodevelopmental outcome in a Swiss National Cohort of extremely premature infants. Pediatrics. 2011; 128: 348.

28. Griffiths R. The Abilities of Babies, 0-2 years. London: University of London Press, 1954.

29. Klinger G., Levy I., Sirota L., et al. Outcome of early-onset sepsis in a national cohort of very low birth weight infants. Pediatrics. 2010; 125 (4): 736-40.

30. Basu S., Agarwal P., Anupurba S., et al. Elevated plasma and cerebrospinal fluid interleukin-1 beta and tumor necrosis factor-alpha concentration and combined outcome of death or abnormal neuroimaging in preterm neonates with early-onset clinical sepsis. J Perinatol. 2015; 35: 855-61.

31. Hentges C., Silveira R., Procianoy R., et al. Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight. J Pediatr (Rio J). 2014; 90: 50-77.

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CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425

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