Assessment of Some Cognitive Disorders in Preterm Infants

Globally, prematurity is a major cause of death and a significant cause of long-term loss of human potential amongst survivors all around the world. Complications of preterm birth are the single largest direct cause of neonatal deaths, responsible for 35% of the world’s 3.1 million deaths a year in almost all countries with reliable data. Preterm birth rates are increasing. An estimated 15 million babies are born too early every year. That is more than 1 in 10 babies. Almost 1 million children die each year due to complications of preterm birth. In addition to its significant contribution to mortality, the effect of preterm birth amongst some survivors may continue throughout life, impairing neuro developmental functioning through increasing the risk of cerebral palsy, learning impairment and visual disorders and affecting long-term physical health with a higher risk of non-communicable disease. The aim of this work is to assess the effect of prematurity on cognitive development in preterm infants at the first year of life and to evaluate the difference between preterm and full term regarding this development. This could help to maximize neurological development and reduce long term cognitive and behavioral problems. Forty -three premature infants (26 female and 17 male) were studied. Twenty-five full term infants of matched age and sex were included in the study as controls. All patients were neurologically free on clinical examination. Anthropometric measurement of patients were recorded at 3, 6, 9, 12 months old and included weight, recumbent length and head circumference. The Griffiths development scale was used to assess the cognitive and psychomotor development status of the infants. They covered locomotor skills, personal/social skills, hearing/speech, eyehand coordination, and cognitive performance . Total intellectual quotients (IQ %) were calculated. The IQ of the studied patients at three months ranged from 61-132% (mean 103.63±14.90), at six months ranged from 51-140% (mean 112.43±22.10), at nine months 40-141% (mean 115.56 ± 27.92) and at twelve months ranged from 95-140% (mean 130.64 ± 14.06). Performance was the most affected parameter in preterm infants, also there was positive correlation between gestational age and IQ % at 6 and12 months, no correlation was found between IQ% and head circumference and IQ% at 6 and 12 months was higher than at 3 and 9 months in preterm infants. Conclusion: Preterm infants have lower IQ scores than full term ones but this delay seems to resolve gradually with age, and at the end of the first year of life they become equal. In spite of the technological advances in neonatology and increased survival of preterm infants, there are still knowledge gaps in this area. Res Pediatr Neonatol Copyright © Ahmed El-Abd Ahmed 75 How to cite this article: Emad MH, Ahmed El-Abd Ahmed, Nagwan I R, Marwa G F. Assessment of Some Cognitive Disorders in Preterm Infants. Res Pediatr Neonatol. 1(5). RPN.000522. 2018. DOI: 10.31031/RPN.2018. 01.000522 Volume 1 Issue 5 availability of neonatal intensive care. To reduce preterm birth rates, women -especially adolescents need better access to family planning and increased empowerment, as well as improved care before, between and during pregnancies [7]. Patients and Methods This randomized controlled clinical study included 43 premature infants, admitted and attended to pediatric departments of Qena university hospital, South Valley University and Nag Hammady hospital, ministry of health. They were assessed at birth, 3, 6, 9 and at 12 months old, and 25 full term infants as a control group matched with age and sex. The patients were classified into groups according to social status into low, medium and high socioeconomic status according to Fahmy & El-Sherbini [8]. All patients were neurologically free on clinical examination. Patients with congenital anomalies, special dysmorphic feature, or patients taken medicine known to influence cognitive development as anti epileptic drugs were excluded from the study. Anthropometric measurement of patients were recorded at 3, 6, 9, 12 months old and included weight, recumbent length and head circumference. The Griffiths development scale translated and standardized for the Egyptian reference population (version 1989), were used to assess the cognitive and psychomotor development status of the infants. They covered locomotor skills, personal/social skills, hearing/ speech, eye hand coordination, and cognitive performance. Total intellectual quotients (IQ%) were calculated by dividing the number of items successfully executed by the infants age (in months) [9]. The study was done after a written consent from the parents, and under the approval of Ethics Committee of Qena University Hospital. Statistical Analysis The study data were statistically analyzed using the Statistical Package for Social version program (SPSS program-version 17.0 SPSS Inc., Chicago, IL. USA). The difference between cases and control as regards quantitative variables was done using ANOVA, F test and Kruskal Wallis. For testing association between categorized variables chi square and Monte Carlo were used. Pearson’s correlation test was done to study possible correlation between quantitative variables. Statistical significance was assessed at P<0.05. All calculated P values were two-tailed. Results Table 1: Demographic information of the studied group. Preterm Infants (n=43) Control (n=25) Tests X2 or t P-value Age Range 32-36 38-43 13.140 <0.001* Mean±SD 35.14±1.37 39.88±1.54