Title: Assessment of the Neuropsychomotor Development in the First Year of Life of Premature Infants with and without Bronchopulmonary Dysplasia.
Authors: Letycia Vieira Silva, Lúcio Dorges de Araújo, Vivian Mara Gonçalves de Oliveira Azevedo
Citation: Silva LV, Araújo LB, Azevedo VM. Assessment of the Neuropsychomotor Development in the First Year of Life of Premature Infants with and without Bronchopulmonary Dysplasia. Rev Bras Ter Intensiva. 2018;30(2):174-180. DOI: 10.5935/0103-507X.20180023
Purpose: The purpose of this study was to look at infants that were born premature, weighing less than 3.3 lbs (1,500g) and with or without bronchopulmonary dysplasia to compare the neuropsychomotor development (NPMD) of these infants during their first year of life.
Study Population/Methods: Between January 1, 2014 and December 30, 2015, a cross sectional retrospective study was performed in Brazil. Researchers looked in the medical archive of a university hospital in Minas Gerais. During the study period, there were 239 infants born premature (gestational age < 37 weeks). Medical records were excluded due to death, transfers, records not found, or the NPMD assessment not found or incomplete. 79 of the 239 infants’ medical records were used for this study. 40 of the infants had the diagnosis of bronchopulmonary dysplasia (BPD) and 39 infants did not have the diagnosis.
Outcome Measures/Interventions: The Denver Developmental Screening Test (2nd Edition) was used to assess the infants at the corrected ages of 6 and 9 months. These ages were determined due to the important motor milestones during that time. Additional variables were divided into quantitative and qualitative variables. The means, medians, and standard deviations were calculated for the quantitative variables and the Shapiro-Wilk normality test, t-tests and/or the Mann-Whitney test was used. A p-value of < 0.05 was considered for significance. Frequencies and percentages were used to describe qualitative variables.
Results: When comparing infants using DDST-II with or without BPD, a significant difference (p = 0.001) was found indicating that infants with BPD had a longer delay in NPMD. A significantly greater number (p = 0.001) of failures in the personal-social domain was seen in infants with BPD.
Strengths/Limitations: By 6 months of age, a child should be able to sit independently and have their hands free from reaching. They should also be able to weight bear fully through legs and bounce with support in standing. There are also multiple reflexes that should be integrated by 6 months and are considered red flags if they are not. At 9 months, children should be more mobile and have some variability of movement skills. One strength of this study is using the Denver Developmental Screening Test to assess neuropsychomotor development. Assessing the NPMD at 6 and 9 months is also a strength. Although, there were 79 medical records that were able to be used, it could be thought of as a limitation that they had to exclude 160 medical records.
Conclusion: The Denver Developmental Screening Test (2nd Edition) is used to monitor children for developmental delays. Bronchopulmonary dysplasia is the most commonly diagnosed chronic lung diseases in neonates and could be a risk factor for changes in NPMD. Using the Denver, researchers wanted to assess for developmental delay in children diagnosed with BPD and comparing to those without BPD. Results show that there is a significant difference in infants with or without BPD when assessing NPMD. Those with BPD had a longer delay in NPMD.