Cumulative hypoxia, socioeconomic deprivation and neurodevelopmental outcomes in preterm infants

Theodore Dassios; Ourania Kaltsogianni; Poonam Belani; Anusha Arasu; Anne Greenough

doi:10.1016/j.resp.2022.103942

Cumulative hypoxia, socioeconomic deprivation and neurodevelopmental outcomes in preterm infants

Theodore Dassios^*, Ourania Kaltsogianni, Poonam Belani, Anusha Arasu, Anne Greenough

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Background: Hypoxia can adversely affect cognition, while socioeconomic deprivation has also been associated with impaired neurodevelopment in the newborn. We aimed to assess the impact of hypoxia and socioeconomic deprivation on the neurodevelopmental outcomes of preterm infants. Methods: Retrospective cohort study at a tertiary neonatal unit between 2015 and 2018. The motor, cognitive and language domain scores of the Bayley-III assessment were recorded at 24 months of corrected gestational age. The percentage of time with pulse oximetry (SpO₂) < 75% was measured from the nursing records, from admission to 36 weeks postmenstrual age in infants born < 30 weeks gestational age. The multiple deprivation index (MDI) and the main care giver's education domain of the MDI were also recorded. Results: A total of 93,767 data points from 80 infants (34 male) with a median (IQR) gestational age of 27.9(25.9–29.0) weeks and a birth weight of 0.94(0.74–1.23) kg were analysed. The median (IQR) motor score [103(91−110)] was significantly related to the median (IQR) time with SpO₂ < 75% [1.5(0.9–3.4)%, adjusted p = 0.020]. The median (IQR) cognitive score [100(90−105)] was negatively significantly related to the time with SpO₂ < 75% (adjusted p = 0.012) and the median (IQR) education decile of the MDI [7(6−9), adjusted p = 0.011]. The median (IQR) language score [91(77−100)] was significantly positively related to the education domain of the MDI (adjusted p = 0.025). Conclusions: Hypoxia in preterm infants exerted a negative impact on motor function and cognition and conversely, higher educational attainment had a positive impact on cognition and language.

Original language	English
Article number	103942
Journal	RESPIRATORY PHYSIOLOGY AND NEUROBIOLOGY
Volume	305
DOIs	https://doi.org/10.1016/j.resp.2022.103942
Publication status	Published - Nov 2022

Keywords

Neurodevelopmental outcomes
Prematurely born infants
Socioeconomic deprivation

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10.1016/j.resp.2022.103942

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@article{b25287c0b75b4c6db4a521dbc6c9973a,

title = "Cumulative hypoxia, socioeconomic deprivation and neurodevelopmental outcomes in preterm infants",

abstract = "Background: Hypoxia can adversely affect cognition, while socioeconomic deprivation has also been associated with impaired neurodevelopment in the newborn. We aimed to assess the impact of hypoxia and socioeconomic deprivation on the neurodevelopmental outcomes of preterm infants. Methods: Retrospective cohort study at a tertiary neonatal unit between 2015 and 2018. The motor, cognitive and language domain scores of the Bayley-III assessment were recorded at 24 months of corrected gestational age. The percentage of time with pulse oximetry (SpO2) < 75% was measured from the nursing records, from admission to 36 weeks postmenstrual age in infants born < 30 weeks gestational age. The multiple deprivation index (MDI) and the main care giver's education domain of the MDI were also recorded. Results: A total of 93,767 data points from 80 infants (34 male) with a median (IQR) gestational age of 27.9(25.9–29.0) weeks and a birth weight of 0.94(0.74–1.23) kg were analysed. The median (IQR) motor score [103(91−110)] was significantly related to the median (IQR) time with SpO2 < 75% [1.5(0.9–3.4)%, adjusted p = 0.020]. The median (IQR) cognitive score [100(90−105)] was negatively significantly related to the time with SpO2 < 75% (adjusted p = 0.012) and the median (IQR) education decile of the MDI [7(6−9), adjusted p = 0.011]. The median (IQR) language score [91(77−100)] was significantly positively related to the education domain of the MDI (adjusted p = 0.025). Conclusions: Hypoxia in preterm infants exerted a negative impact on motor function and cognition and conversely, higher educational attainment had a positive impact on cognition and language.",

keywords = "Neurodevelopmental outcomes, Prematurely born infants, Socioeconomic deprivation",

author = "Theodore Dassios and Ourania Kaltsogianni and Poonam Belani and Anusha Arasu and Anne Greenough",

note = "Funding Information: The research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas{\textquoteright} NHS Foundation Trust and King's College London, UK. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Publisher Copyright: {\textcopyright} 2022 Elsevier B.V.",

year = "2022",

month = nov,

doi = "10.1016/j.resp.2022.103942",

language = "English",

volume = "305",

journal = "RESPIRATORY PHYSIOLOGY AND NEUROBIOLOGY",

issn = "1569-9048",

publisher = "Elsevier",

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TY - JOUR

T1 - Cumulative hypoxia, socioeconomic deprivation and neurodevelopmental outcomes in preterm infants

AU - Dassios, Theodore

AU - Kaltsogianni, Ourania

AU - Belani, Poonam

AU - Arasu, Anusha

AU - Greenough, Anne

N1 - Funding Information: The research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London, UK. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Publisher Copyright: © 2022 Elsevier B.V.

PY - 2022/11

Y1 - 2022/11

N2 - Background: Hypoxia can adversely affect cognition, while socioeconomic deprivation has also been associated with impaired neurodevelopment in the newborn. We aimed to assess the impact of hypoxia and socioeconomic deprivation on the neurodevelopmental outcomes of preterm infants. Methods: Retrospective cohort study at a tertiary neonatal unit between 2015 and 2018. The motor, cognitive and language domain scores of the Bayley-III assessment were recorded at 24 months of corrected gestational age. The percentage of time with pulse oximetry (SpO2) < 75% was measured from the nursing records, from admission to 36 weeks postmenstrual age in infants born < 30 weeks gestational age. The multiple deprivation index (MDI) and the main care giver's education domain of the MDI were also recorded. Results: A total of 93,767 data points from 80 infants (34 male) with a median (IQR) gestational age of 27.9(25.9–29.0) weeks and a birth weight of 0.94(0.74–1.23) kg were analysed. The median (IQR) motor score [103(91−110)] was significantly related to the median (IQR) time with SpO2 < 75% [1.5(0.9–3.4)%, adjusted p = 0.020]. The median (IQR) cognitive score [100(90−105)] was negatively significantly related to the time with SpO2 < 75% (adjusted p = 0.012) and the median (IQR) education decile of the MDI [7(6−9), adjusted p = 0.011]. The median (IQR) language score [91(77−100)] was significantly positively related to the education domain of the MDI (adjusted p = 0.025). Conclusions: Hypoxia in preterm infants exerted a negative impact on motor function and cognition and conversely, higher educational attainment had a positive impact on cognition and language.

AB - Background: Hypoxia can adversely affect cognition, while socioeconomic deprivation has also been associated with impaired neurodevelopment in the newborn. We aimed to assess the impact of hypoxia and socioeconomic deprivation on the neurodevelopmental outcomes of preterm infants. Methods: Retrospective cohort study at a tertiary neonatal unit between 2015 and 2018. The motor, cognitive and language domain scores of the Bayley-III assessment were recorded at 24 months of corrected gestational age. The percentage of time with pulse oximetry (SpO2) < 75% was measured from the nursing records, from admission to 36 weeks postmenstrual age in infants born < 30 weeks gestational age. The multiple deprivation index (MDI) and the main care giver's education domain of the MDI were also recorded. Results: A total of 93,767 data points from 80 infants (34 male) with a median (IQR) gestational age of 27.9(25.9–29.0) weeks and a birth weight of 0.94(0.74–1.23) kg were analysed. The median (IQR) motor score [103(91−110)] was significantly related to the median (IQR) time with SpO2 < 75% [1.5(0.9–3.4)%, adjusted p = 0.020]. The median (IQR) cognitive score [100(90−105)] was negatively significantly related to the time with SpO2 < 75% (adjusted p = 0.012) and the median (IQR) education decile of the MDI [7(6−9), adjusted p = 0.011]. The median (IQR) language score [91(77−100)] was significantly positively related to the education domain of the MDI (adjusted p = 0.025). Conclusions: Hypoxia in preterm infants exerted a negative impact on motor function and cognition and conversely, higher educational attainment had a positive impact on cognition and language.

KW - Neurodevelopmental outcomes

KW - Prematurely born infants

KW - Socioeconomic deprivation

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U2 - 10.1016/j.resp.2022.103942

DO - 10.1016/j.resp.2022.103942

M3 - Article

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AN - SCOPUS:85133907611

SN - 1569-9048

VL - 305

JO - RESPIRATORY PHYSIOLOGY AND NEUROBIOLOGY

JF - RESPIRATORY PHYSIOLOGY AND NEUROBIOLOGY

M1 - 103942

ER -

Cumulative hypoxia, socioeconomic deprivation and neurodevelopmental outcomes in preterm infants

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