Investigation of risk factors affecting the neurological development of patients with A history of premature birth

ABSTRACT Aim: The aim of this study is to investigate the relationship between prenatal, natal and postnatal risk factors affecting the neurological development of patients with a history of premature birth and to determine appropriate approaches in neurology follow-up. Materials and Methods: Patients with a history of premature birth who admitted to Ondokuz Mayıs University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology between January 01, 2020 and January 01, 2021, were followed up in the pediatric neurology outpatient clinic. It is a retrospective study that includes medical history, laboratory parameters, cranial ultrasonography (USG) and magnetic resonance imaging, electroencephalography, neuropsychometric evaluations through Hospital Information Management System Records. Results: While 89 (45.2%) of the 197 patients were female and 108 (54.8%) were male, the actual age at the last evaluation was 50.02±44.86 months. It was noted that 183 (92.9%) of the deliveries were cesarean section. There were 117 (59.4%) patients with 5th minutes Apgar score of seven and below. It was observed that there were 69 (35%) patients with severe and very preterm, and 28 (14.2%) patients with extremely low birth weight. Cranial USG was performed in 115 patients in the neonatal intensive care unit, 43 (37.3%) had abnormalities, 117 patients underwent cranial MRI, 86 (73.6%) had abnormality, 28 (14.2%) patients had seizure history, 48 Seizure was detected in the patient (24.4%) in the neurology follow-up. In the last examination of the patients during follow-up, abnormal neurological findings was observed in 120 (60.9%) patients, and abnormality was found in 61 (30.9%) of 101 patients who underwent Denver Developmental Screening Test-II. It was observed that 90 (45.7%) patients received special education. In low birth weight patients (p=0.038), birth week (<32 weeks) (p=0.004), 5th minute APGAR score (≤6) (p=0.007), female gender (p=0.005) more cranial magnetic resonance abnormalities was found to be. At the same time, it was determined that cranial magnetic resonance results were more abnormal in patients who had a long hospital stay in the intensive care unit (p=0.004) and needed intubation (p=0.02). When the electroencephalograms of the patients were compared with the gestational week, it was detected that there was abnormality in moderately preterms (p=0.039). A significant difference was found between the seizure history and electroencephalography results in neurology follow-up (p=0.001). Conclusion: We observed that negatively affect the neurodevelopmental process of preterm infants which of low birth weight very and extremely preterm, 5th minute Apgar score under seven, length of stay in neonatal intensive care unit, female gender, need for intubation, and seizures in long-term follow-up as risk factors that negatively affect the neurodevelopmental process of preterm infants. Key Words: Premature, Neurodevelopment Prognosis, Low Birth Weight