Encephalopathy of premature infants: emergence of primary disability in the class of nervous diseases at an early age

Abstract

Objective. To determine the frequency of encephalopathy of prematurity (EPP) in prematurely born children with different gestational ages and the rates of primary disability according to the class of nervous diseases at the age of 2 years.
Materials and methods. A retrospective-prospective study included 212 premature babies born between 26 and 37 weeks of gestation. Two groups were formed: group 1 — newborns diagnosed with encephalopathy of prematurity in the neonatal period (n = 75); group 2 — newborns without EPP (n = 137). EPP indicators were compared with neurodevelopmental outcomes at the age of 2 years. The indices of EPP were compared with the outcomes of neurodevelopment at the age of 2 years.
Results. Among all premature infants with EPP in the neonatal period, disability at the age of 2 years was established in 45.3 % (34 cases), which is 12.6 times higher compared to 3.6 % (5 cases) without EPP, Fisher’s (p < 0.001). The presence of EPP in the neonatal period of premature infants increases the likelihood of disability at an early age according to the class of nervous diseases by 22 times (OR = 21.89; 95 % CI (8.04—59.63)) compared to the disability rate in premature infants without EPP (Fisher’s p < 0.001). Among all premature infants with EPP in the neonatal period, limitations of life activity criteria (signs of disability) at the age of 2 years were detected in 52.0 % (39 cases), which is 5 times higher compared to children without EPP in the neonatal period — 9.5 % (13 cases) (Fisher’s p < 0.001).
Conclusion. The presence of EPP in the neonatal period of premature infants increases the likelihood of disability at an early age according to the class of nervous diseases by 22 times (OR = 21.89; 95 % CI (8.04—59.63)) compared to the disability rate in premature infants without EPP (Fisher’s p < 0.001), this fact justifies the mandatory implementation of medical habilitation starting from the neonatal period.