Neonatal Morbidities, Neurodevelopmental Impairments, and Positive Health among Children Surviving Birth before 32 Weeks of Gestation

J Wells Logan; Xiaodan Tang; Rachel G Greenberg; Brian Smith; Lisa Jacobson; Courtney K Blackwell; Mark Hudak; Judy L Aschner; Barry Lester; T Michael O'Shea; Program Collaborators for Environmental Influences on Child Health Outcomes

doi:10.1016/j.jpeds.2024.114376

Neonatal Morbidities, Neurodevelopmental Impairments, and Positive Health among Children Surviving Birth before 32 Weeks of Gestation

J Pediatr. 2024 Oct 30:277:114376. doi: 10.1016/j.jpeds.2024.114376. Online ahead of print.

Collaborators

Program Collaborators for Environmental Influences on Child Health Outcomes:
S L Teitelbaum, A Stroustrup, S Merhar, A Lampland, A Reynolds, G Pryhuber, P Moore, L Washburn, B Carter, S Pastyrnak, C Neal, L Smith, J Helderman, R Vaidya, R Obeid, C Rollins, K Bear, M Lenski, R Singh, M Msall, J Frazier, S Gogcu, A Montgomery, K Kuban, L Douglass, H Jara, R Joseph

Affiliations

¹ Department of Pediatrics, University of Florida College of Medicine - Jacksonville, Jacksonville, FL.
² Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
³ Department of Pediatrics, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
⁴ Department of Pediatrics, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC; Principal Investigator, Environmental and Child Health Outcomes (ECHO) Study, Duke University Medical Center, Durham, NC.
⁵ Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
⁶ The Center for Discovery and Innovation at Hackensack Meridian Health, Hackensack Meridian School of Medicine, Nutley, NJ; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY.
⁷ Center for the Study of Children at Risk at the Brown Alpert Medical School, Brown University, Providence, RI.
⁸ Department of Pediatrics, University of North Carolina College of Medicine, Chapel Hill, NC.

PMID: 39481800
DOI: 10.1016/j.jpeds.2024.114376

Abstract

Objectives: To evaluate positive health outcomes among children born at < 32 weeks of gestation and to determine whether children with three common neonatal morbidities and 2 neurodevelopmental impairments would have similar positive health outcomes to children and adolescents without these exposures and impairments.

Study design: In this secondary analysis of prospectively acquired data derived from 3 multicenter cohorts of children born very preterm (the Extremely Low Gestational Age Newborn cohort [birth years 2001 to 2004], the Neurobehavior And Outcomes in Very Preterm Infants cohort [birth years 2014 to 2016], and the Developmental Impact of Neurobehavior And Outcomes in Very Preterm Infants Exposures cohort [birth years 2010 to 2020]), we examined associations between the 3 common neonatal morbidities (bronchopulmonary dysplasia, necrotizing enterocolitis, and intraventricular hemorrhage, diagnosed before hospital discharge), 2 neurodevelopmental impairments (developmental delays and cerebral palsy, diagnosed at preschool age follow-up), and perceptions of physical, mental, and social well-being (in either early childhood or adolescence), using the Patient-Reported Outcomes Measurement Information System scales for positive health.

Results: After adjusting for confounders, bronchopulmonary dysplasia, intraventricular hemorrhage, and cerebral palsy were associated with lower positive health scores, reported by parent-proxy during early childhood. None of the exposures or impairments were associated with lower positive health scores at adolescence, reported by the children themselves.

Conclusion: Parents of children born very preterm with bronchopulmonary dysplasia, intraventricular hemorrhage, or cerebral palsy rated their children's positive health lower than did parents of children without these morbidities. However, adolescents' own reports of positive health outcomes were not associated with either neonatal pre-discharge morbidities or preschool neurodevelopmental impairments.

Keywords: bronchopulmonary dysplasia; intraventricular hemorrhage; morbidity; necrotizing enterocolitis; neonatal; positive health; well-being.