Midterm Neuromotor Development Results of Preterm Babies less than 34 Weeks Gestational Age

Objectives: This study aimed to evaluate the neuromotor development of premature babies and to determine the risk factors affecting neuromotor development in the middle time (3 years).
Methods: All babies with ≤34 weeks gestational age and born between 2011-2014 and hospitalized in our neonatal clinic were included in this study. Prenatal, perinatal and postnatal features of the babies were recorded. Consent was obtained from the families who had an outpatient follow-up and agreed to participate in this study. Neurological examination and Denver II Developmental Screening Test (DDST-II) were applied to babies and their results were recorded. Factors affecting neurodevelopment were evaluated.
Results: Complete data for 96 of the study infant were obtained. Fifty (52.1%) of the cases were female. The mean birth weight was 1542±518 grams. The mean corrected age was 20.9±10.7 months at the time of the examination. It was found cerebral palsy in 11 babies (11.5%) with the neurological examination and developmental retardation in 15 babies (15.6%) with DDST-II. Low birth weight, a gestational period of 25-26 weeks, Apgar score at 5th minute <7 were found to be the main risk factors for cerebral palsy and abnormal DDST-II result (p<0.05). In babies with abnormal neurological examination, the frequency of bronchopulmonary dysplasia, sepsis and intraventricular hemorrhage were found to be high (p<0.05), and in babies with abnormal DDST-II results the frequency of respiratory distress syndrome, bronchopulmonary dysplasia and sepsis were found to be high (p<0.05).
Conclusion: In our study, abnormal neurological examination rate was found 11.5% in preterm infants with gestational age ≤34 weeks, and the rate of abnormal DDST-II was found 15.6%. The main factors affecting neuromotor development were gestational week, birth weight and 5th minute Apgar score. The frequency of bronchopulmonary dysplasia, sepsis and intraventricular hemorrhage in babies with abnormal neurological examination, and the frequency of respiratory distress, bronchopulmonary dysplasia and sepsis were found to be high in babies with abnormal DDST-II.

Gebelik süresi 34 hafta altýndaki preterm bebeklerin orta dönem nöromotor geliþim sonuçlarý

Amaç: Çalýþmamýzda prematüre bebeklerin orta dönemde (3 yaþ) nöromotor geliþimini deðerlendirmek ve nöromotor geliþimine etki eden risk faktörlerini belirlemek amaçlandý.
Gereç ve Yöntem: Hastanemizde 2011-2014 tarihleri arasýnda doðan ve yenidoðan kliniðimize yatýrýlan, gebelik haftasý 34 hafta ve altýnda olan tüm bebekler çalýþmaya alýndý. Hastalarýn prenatal, perinatal ve postnatal özellikleri kaydedildi. Poliklinik takibi olan ve çalýþmaya katýlmayý kabul eden ailelerden çalýþma onamý alýndý. Bebeklere nörolojik muayene ve Denver II Geliþimsel Tarama Testi (DGTT-II) uygulanarak sonuçlarý kaydedildi. Nörogeliþim üzerine etki eden faktörler incelendi.
Bulgular: Çalýþma süresince 96 bebeðin tam verisi elde edildi. Olgularýn 50’si (% 52,1) kýz idi. Bebeklerin doðum kilosu ortalama 1542,1±518,5 gram iken, muayene sýrasýndaki düzeltilmiþ yaþlarýnýn ortalamasý 20,9±10,7 ay idi. Nörolojik muayene ile 11 bebekte (%11,5) serebral palsi, DGTT-II ile 15 bebekte (% 15,6) geliþimsel gerilik saptandý. Düþük doðum aðýrlýðý, gebelik süresinin 25-26 hafta olmasý, Apgar skorunun 5.dakikada <7 olmasý serebral palsi ve anormal DGTT-II sonucu için ana risk faktörleri olduðu (p<0.05) belirlendi. Anormal nörolojik muayenesi saptanan bebeklerde bronkopulmoner displazi, sepsis, intraventriküler kanama sýklýðý yüksek saptandý (p<0.05). Anormal DGTT-II sonucu olan bebeklerde ise respiratuvar distress sendromu, bronkopulmoner displazi ve sepsis sýklýðý yüksek saptandý (p<0.05).
Sonuç: Çalýþmamýzda doðum süresi 34 haftanýn altýnda olan preterm bebeklerde anormal nörolojik muayene oraný %11,5 ve anormal DGTT-II oraný %15,6 olarak saptandý. Nöromotor geliþimi etkileyen ana faktörlerin gebelik haftasý, doðum aðýrlýðý ve 5. dakika Apgar skoru olduðu görüldü. Anormal nörolojik muayenesi olan bebeklerde bronkopulmoner displazi, sepsis ve intraventriküler kanama sýklýðý, anormal DGTT-II sonucu olan bebeklerde ise respiratuvar distres, bronkopulmoner displazi ve sepsis sýklýðý yüksek oranda saptandý. (SETB-2020-02-026)