School performance in adolescents with and without periventricular-intraventricular hemorrhage in the neonatal period☆
Section snippets
Methods
During 1983, infants born in the Netherlands with a gestational age of less than 32 completed weeks and/or a birth weight below 1500 g participated in a prospective national survey on morbidity and mortality, which had a compliance rate of 94%.14 At that time, cranial ultrasound was routinely and systematically performed in 6 of the 8 neonatal intensive care units in the country. We studied prospectively the incidence of PIVH and subsequent neurodevelopmental outcome in a cohort of 484 infants
Results
School performance data at the age of 14 years were obtained from 278 (91.5%) of the 304 surviving adolescents. One hundred and twenty-nine (46.4%) adolescents performed normally in school; 107 (38.5%) appeared to be slow learners, whereas 42 (15.1%) participated in special education. The level of secondary education in relation to school performance is presented in Table 1. When compared with slow learners, adolescents with a normal school performance attended more frequently level A
Discussion
The compliance rate of our study was very high (91.5%). The overall school performance of our study cohort did not differ from the school performance of the remaining POPS cohort. School performance in our study cohort, however, was considerably poorer than in the general Dutch population (46.4% versus 80.6% normal performers, 38.5% versus 14.7% slow learners, and 15.1% versus 4.7% in special education) at 14 years of age.21 The worrisome finding that less than 50% of this very preterm born
Conclusion
We observed that less than 50% of adolescents born before 32 weeks gestation have a normal school performance. While PIVH, even the lower grades, was related to disability at the age of 5 years, we now demonstrate that PIVH also has an unfavorable additional effect on school performance.
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Cited by (32)
Decision-making for extremely preterm infants with severe hemorrhages on head ultrasound: Science, values, and communication skills
2023, Seminars in Fetal and Neonatal MedicineNeonatal Intraventricular Hemorrhage and Hospitalization in Childhood
2020, Pediatric NeurologyCitation Excerpt :These children are at increased risk of cerebral palsy and neurosensory impairment, including seizures, language delay, and behavioral disorders, inevitably affecting activities of daily living and quality of life.1,5-7 They may need special educational support at school,8 which is associated with additional costs. Emerging research is showing that very low birth weight infants with neonatal comorbidities, including intraventricular hemorrhage, may have higher rates of orthopedic and ophthalmological hospitalizations,9 but data remain otherwise scarce.
Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants
2018, Early Human DevelopmentCitation Excerpt :Cerebral blood flow autoregulation may be impaired in critically ill premature infants in the first days of life, and for infants requiring vasopressors, the autoregulation might be impaired even with low fluctuations of blood pressure [28]. IVH leads to short, medium and long-term sequelae, as seizures, intracranial hypertension, hydrocephalus, cerebral palsy, mental retardation and poor school performance [5–8,29]. The recommendation to perform a LP for infants with suspected early-onset sepsis is controversial.
Childhood outcomes after low-grade intraventricular haemorrhage: A systematic review and meta-analysis
2024, Developmental Medicine and Child NeurologySchool-age outcomes of children after perinatal brain injury: A systematic review and meta-analysis
2023, BMJ Paediatrics Open
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This study is part of the Project on Preterm and Small for gestational infants in the Netherlands (POPS).