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  • Clinical Research Article
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Divergent neurodevelopmental profiles of very-low-birth-weight infants

Pediatric Research volume 95, pages 233–240 (2024)Cite this article

Abstract

Background

Advanced perinatal medicine has decreased the mortality rate of preterm infants. Long-term neurodevelopmental outcomes of very-low-birth-weight infants (VLBWIs) remain to be investigated.

Methods

Participants were 124 VLBWIs who had in-hospital birth from 2007 to 2015. Perinatal information, developmental or intelligence quotient (DQ/IQ), and neurological comorbidities at ages 3 and 6 years were analyzed.

Results

Fifty-eight (47%) VLBWIs received neurodevelopmental assessments at ages 3 and 6 years. Among them, 15 (26%) showed DQ/IQ <75 at age 6 years. From age 3 to 6 years, 21 (36%) patients showed a decrease (≤–10), while 5 (9%) showed an increase (≥+10) in DQ/IQ scores. Eight (17%) with autism spectrum disorder or attention-deficit hyperactivity disorder (ASD/ADHD) showed split courses of DQ/IQ, including two with ≤–10 and one with +31 to their scores. On the other hand, all 7 VLBWIs with cerebral palsy showed DQ ≤35 at these ages. Magnetic resonance imaging detected severe brain lesions in 7 (47%) of those with DQ <75 and 1 (18%) with ASD/ADHD.

Conclusions

VLBWIs show a broad spectrum of neurodevelopmental outcomes after 6 years. These divergent profiles also indicate that different risks contribute to the development of ASD/ADHD from those of cerebral palsy and epilepsy in VLBWIs.

Impact

  • Very-low-birth-weight infants (VLBWIs) show divergent neurodevelopmental outcomes from age 3 to 6 years.

  • A deep longitudinal study depicts the dynamic change in neurodevelopmental profiles of VLBWIs from age 3 to 6 years.

  • Perinatal brain injury is associated with developmental delay, cerebral palsy and epilepsy, but not with ASD or ADHD at age 6 years.

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Fig. 1: Participants of this study.
Fig. 2: The developmental and intelligence quotients of 58 VLBWIs at age 3 and 6 years.
Fig. 3: Neuroimaging data of VLBWIs at discharge from NICU.

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Data availability

All data are available in the main manuscript and Supplementary information.

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Acknowledgements

We thank Drs Toshiro Hara (President Fukuoka Children’s Hospital, Professor Emeritus at Kyushu University), and Ryutaro Kira (Fukuoka Children’s Hospital) for their cordial support of this research; Drs Takeshi Shono and Kumiko Shono (Department of Pediatric Surgery, KMC) for the management of patients; and all physicians and co-medical staff in our department for helpful discussions.

Funding

This study was supported by JSPS KAKENHI grant numbers JP19K10613 (P.F.C.), JP18K15677 (Y.S.), JP17K16271 (Y.I.), JP19K08281 (Y.S.); AMED grant numbers JP20ek0109411, JP20wm0325002h; Research grant for prion diseases from the Ministry of Health, Labour and Welfare of Japan (JP20FC1054); The Japan Epilepsy Research Foundation, and Kawano Masanori Memorial Public Interest Incorporated Foundation for Promotion of Pediatrics (Y.S.).

Author information

Author notes

  1. These authors contributed equally: Reina Ogata, Kyoko Watanabe.

Authors and Affiliations

  1. Department of Pediatrics, National Hospital Organization Kokura Medical Center, Kitakyushu, 802-8533, Japan

    Reina Ogata, Kyoko Watanabe, Jun Okamoto, Yoshihiro Sakemi, Toshinori Nakashima, Takuro Ohno & Hironori Yamashita

  2. Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan

    Pin Fee Chong, Yuri Sonoda, Yuko Ichimiya, Hirosuke Inoue, Masayuki Ochiai, Yasunari Sakai & Shouichi Ohga

  3. Department of Radiology, National Hospital Organization Kokura Medical Center, Kitakyushu, 802-8533, Japan

    Hiroyuki Nomiyama

  4. Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan

    Yuri Sonoda & Masayuki Ochiai

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  1. Reina Ogata
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Contributions

R.O., K.W., P.F.C., and Y.S. analyzed data and drafted the manuscript. R.O., K.W., and J.O. performed the neurodevelopmental tests. T.N., Y. Sakemi, T.O., Y. Sonoda, Y.I., H.I., and M.O. managed the patients and analyzed data. H.Y. and S.O. conceptualized and organized the grand-design of this study. All of the authors critically reviewed and approved the final form of this manuscript.

Corresponding authors

Correspondence to Kyoko Watanabe or Yasunari Sakai.

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The authors declare no competing interests.

Ethics approval

This study was approved by the Institutional Review Boards at KMC (REC2021–024) and Kyushu University (#29-628 and #29-635).

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Ogata, R., Watanabe, K., Chong, P.F. et al. Divergent neurodevelopmental profiles of very-low-birth-weight infants. Pediatr Res 95, 233–240 (2024). https://doi.org/10.1038/s41390-023-02778-w

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