Influence of gait analysis on decision-marketing for lower extremity surgery

Increased neurodevelopmental delays in preterm multiples with birthweight less than 1500g

IA MICHALEC MD, C RITTENBERG MD, M EBELING MD,
M M MACIAS MD, T C HULSEY MSPH SCD, L D KATIKANENI MD

  1. 1. Medical University of South Carolina, Charleston, SC, USA

Background: Multiple gestations are known to be at increased risk for neurodevelopmental delay (NDD). Perinatal factors that contribute to these delays have yet to be determined.

Design: Retrospective analysis of a computerized database for neonatal intensive care unit stay and from a high-risk developmental follow-up clinic over a 9-year period.

Setting: Tertiary care medical center.

Participants: Seven hundred and thirty-three infants, birth-weight <1500g.

Method: Participants included 170 twins/triplets (23.19%) and 563 singletons (76.81%). Pertinent perinatal variables were compared between the groups. Neurodevelopment was assessed at 12 months adjusted age in visual-motor problem solving, language, and gross motor domains using the Capute Scales and gross motor assessment. Developmental quotient <80 in one or more areas was considered NDD.

Results: Groups were compared using X 2, non-parametric analysis, and regression analysis. Specific variables separating multiples from singletons were identified; p<0.05 was considered significant (Table B:3). Multiples had increased NDD with adjusted developmental quotient (ADQ) <80 in one or more areas (30.61% vs 22.7%; p=0.037). In infants with ADQ <80 in one or more areas, there was no difference in the Ponderal index between the multiples and singletons. Monochorionic multiples had increased incidence of NDD compared with dichorionic multiples (92.3% vs 69.6%; p=0.03). There was no difference in birthweight or gestational age between monoand didichorionic multiples. Regression analysis showed that chorionicity and bacterial sepsis were significant.

Conclusion:  Twins/triplets with birthweight <1500g have an increased rate of NDD at 12 months compared with singletons, in spite of a significant decrease in perinatal risk factors. Among the multiples, monochorionic neonates had increased incidence of NDD compared with dichorionic neonates, even though birthweights and gestational ages were similar. Parental counseling and early intervention may improve the NDD of these infants.

 
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