Long-term predictivity of early neurological assessment and developmental trajectories in low-risk preterm infants

Abstract:

Preterm birth is defined by the WHO as a live birth before 37 completed weeks of gestation and an increase has been recently recorded, representing nowadays the 10,6% of all births. Prematurity is considered a risk factor both for shorter- and longer-term complications and it is related to altered neurodevelopmental trajectories. Although preterm infants usually show good outcomes, part of them may develop significant and long-lasting neurological sequelae, especially in children born under 32 weeks or less of gestational age. Many studies have analyzed predictive factors for developing severe neurodevelopmental outcomes (cerebral palsy, other motor and socio-relational disorders such as autism, etc.). In this study, 148 preterm infants born between 28+0-36+6 weeks were enrolled to investigate the neurodevelopmental trajectories in a population of low-risk premature infants using standardized assessment methods (GMs, HINE, and GMDS) and to verify their validity and predictivity for adverse neurodevelopmental outcomes in low-risk infants. We found a significant correlation between GMs scores and HINE global scores at 3-, 6-, and 9-months corrected age (CA). Better GMA also had a significant correlation to higher scores in the subsection Movements at 3-, 6-, and 9-months CA, with the subsection Posture at 6- and 9-months CA, and with the subsection Tone at 3- and 6-months CA. It supports the idea that spontaneous movements such GMs are necessary for developing an appropriate quality of movements, posture and tone during the first year of age. GMDS general development quotient (87 ± 15,7) and Hearing and language scores (82.3 ± 22.6) appeared to be slightly below the standard. On the contrary, the HINE subsections revealed many interesting correlations between the GMDS Global Development score and the different scales, considering the chronological age. In particular, at the 6-months CA evaluation, significant correlation emerged between the subsection Cranial nerves and the Global development score, the Locomotor scale, and the Eye and Hand Coordination scale; the subsection Tone had a significant correlation with the Performance scale; the subsection Reflexes had a significant correlation with the Locomotor scale. At 9-months CA evaluation, the subsection Movements had a significant correlation with the Locomotor scale. Finally, an important data is represented by the fact that the Global Development score assessed for CA is largely within the normal range, while it is slightly below the lower normal value if assessed for chronological age. This study underlines the importance of including even these low-risk populations in the follow-up programs to early identify infants at risk for adverse long-term impairments and introduce early intervention therapies for optimizing neurodevelopmental outcomes.

Biography:

Prof. Gabriella Di Rosa was born in Messina, Italy, on November 26^th , 1975. She graduated in Medicine and Surgery Degree Course at the Medical School of the University of Messina, Messina, Italy on 2000 and achieved the residency degree of “Child Neuropsychiatrist” on 2006.

Since 22/12/2011- ongoing: prof. Di Rosa, clinical and research position at Unit of Child Neuropsychiatry, University Hospital of Messina.
Since 2014 ongoing:Head of the outpatient unit of neonatal-infantile neurology (0-24) (follow-up of the preterm and at-risk infant). She gained the Italian national Scientific Board, associate professor, MACROAREA 06/G1 “General and Specialistic Pediatrics and Child Neuropsychiatry” (ART. 16 L.240/2010) April 10^th2017.
Since May, 2019 ongoing: Prof. Di Rosa gained the role of Head of Unit of Child Neuropsychiatry, University Hospital of Messina, according to resolution of the General Director # 0009983/2019 May 23rd 2019.
Since October 15^th 2021 she was named Head of the Degree Course on Neuropsychomotor therapy of the Developing Age, University of Messina, Messina, Italy.
Since May 31the, 2021 she is the Director of the Child Neurology and Psychiatry Residency School, University of Messina, Messina, Italy.