1 in 5 Healthy-at-Discharge Preemies Have Neuro Impairment at Age 2

February 6, 2014

About 20% of premature babies who appear healthy at discharge have cerebral palsy or neurological impairment at age 2 years, suggesting that all preemies need early childhood evaluation.

Among children delivered before 34 weeks’ gestation, there is a correlation between initial neonatal and early childhood outcomes, according to a study presented today at the Society for Maternal-Fetal Medicine’s 34th annual meeting, The Pregnancy Meeting™, in New Orleans.

Preterm babies are at high risk for death and other serious medical complications, and some premature infants continue to experience side effects from prematurity even during later childhood. It’s uncertain whether a diagnosis of intestinal problems, severe respiratory problems, a brain bleed, or other complications during a preemie’s stay in the NICU after birth will continue to cause health complications later in childhood.

This study examined more than 1,700 babies who were born prematurely at less than 34 weeks’ gestation. It then followed babies after they were discharged from the NICU and re-evaluated them as 2-year-olds for evidence of cerebral palsy and neurological impairment.

Results revealed that about 1 in 5 babies who appeared healthy at the time of hospital discharge had cerebral palsy or neurological impairment at 2 years of age. Furthermore, 1 in 3 babies who had 1 or more serious complication during their NICU stay also had these complications.

“Babies delivered preterm are at high risk for complications as newborns and also later in childhood,” said Tracy Manuck, MD, one of the researchers and co-director of the University of Utah Prematurity Prevention Clinic. “We found that babies who had serious complications in the newborn intensive care unit were more likely to have cerebral palsy or neurologic impairment in early childhood, but not necessarily. The converse is also true, as about 1 in 5 babies who appeared healthy at the time of hospital discharge had complications in early childhood. Early childhood evaluation and interventions should not be withheld from seemingly healthy previous preterm children.”

However, Dr Manuck noted that the relationship between serious NICU complications and serious neurological impairment in early childhood was not perfect, as the NICU complications were only moderately predictive of prognosis later in childhood.