Table 3.
Long-term clinical, visual, neurological and neurodevelopmental outcomes of 37 survivors of extreme NH by gestational age category
| Gestational age <35 weeks (n=11) |
Gestational age ≥35 weeks (n=26) | All (n=37) |
|
| General characteristics | |||
| Age at testing (months) (median, IQR) | 62.5 (36.5–93.0) | 43.8 (34–64.5) | 51.0 (35–81) |
| Age <4 years old | 3 (27.3) | 13 (50.0) | 16 (43.2) |
| Gender (male) | 4 (36.4) | 16 (61.5) | 20 (54.1) |
| First born | 8 (72.7) | 12 (46.2) | 20 (54.1) |
| Received exchange transfusion | 0 | 3 (11.5) | 3 (8.1) |
| Refugee status | 7 (63.6) | 16 (61.5) | 23 (62.2) |
| Clinical outcomes | |||
| Being unwell* | 3 (27.3) | 8/25 (32.0) | 11/36 (30.6) |
| Stunting† | 2 (18.2) | 13 (50.0) | 15 (40.5) |
| Teeth abnormality‡ | 5/10 (50.0) | 13/26 (50.0) | 18/36 (50.0) |
| Visual and neurological outcomes | |||
| Visual examination abnormality§ | 1 (9.1) | 7 (26.9) | 8 (21.6) |
| Neurological exam abnormality¶ | 0 | 2 (7.7) | 2 (5.4) |
| Neurodevelopmental outcomes | |||
| Maternal perception of child’s development: mother has worries | 3 (27.3) | 3 (11.5) | 6 (16.2) |
| General GMDS percentile score, median (IQR) | 32 (11–42) | 7 (<1–42) | 11 (2–42) |
| Poor development (<10th centile) | 2 (18.2) | 14 (53.8) | 16 (43.2) |
| Delayed development (10-49th centile) | 7 (63.6) | 10 (38.5) | 17 (46.0) |
| Normal development (≥50th centile) | 2 (18.2) | 2 (7.7) | 4 (10.8) |
| Locomotion score, median (IQR) | 34 (19–59) | 12 (3–58) | 19 (5–58) |
| Personal and social score, median (IQR) | 23 (8–94) | 32 (15–64) | 26 (11–64) |
| Hearing and language score, median (IQR) | 12 (6–57) | 11 (<1–33) | 11 (<1–33) |
| Eye and hand coordination score, median (IQR) | 27 (4–46) | 14 (4–48) | 22 (4–46) |
| Performance score, median (IQR) | 26 (6–80) | 3 (<1–19) | 4 (<1–40) |
| Practical reasoning score, median (IQR)** | 18 (2–51) | 11 (1–43) | 14 (2–49) |
Data shown in number and percentage (%).
*Being unwell: more than one hospitalisation per year or presence of a chronic disease as reported in the child’s medical booklet.
†Stunting: height-for-age z-scores below −2 as calculated with WHO Child Growth Standards (http://www.who.int/childgrowth/en/).
‡Teeth abnormality: judgement of medical staff looking for the presence of black staining or cavities, confirmed by first author through photographic records.
§Visual examination abnormality: unconjugated eye movement and Cardiff’s binocular visual contrast and visual acuity lower than the normal values by age categories (instructions manual for the Cardiff Acuity Test).
¶Neurological examination abnormality: judgement of the medical staff after general observation while moving, and evaluating tone, strength and sensibility, coordination, gait and posture, and reflexes.
**One child had an adjusted age of <2 years old when tested; therefore, practical reasoning was available for only 10 preterm children.
EGA, estimated gestational age; GMDS, Griffiths Mental Development Scale; NH, neonatal hyperbilirubinaemia; SCBU, special care baby unit.