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Children
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Neurodevelopmental Disabilities in Neonates
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Neurodevelopmental Disabilities in Neonates

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Child Neurology".

Deadline for manuscript submissions: closed (25 October 2022) | Viewed by 10960

Special Issue Editor

Dr. Gire Catherine

E-Mail Website
Guest Editor
Department of Neonatology, North Hospital, APHM University Hospital, 13015 Marseille, France
Interests: neurodevlopment; quality of life; brain imaging; devlopment care

Special Issue Information

Dear Colleagues,

Large population-based studies reporting on the fate of prematurely born children have mainly focused on children born extremely preterm and less on children born very or moderately preterm. However, changes in care have been substantial for all groups of preterm infants, and infants born very or moderately preterm represent a large proportion of those with developmental difficulties. Since the advent of neuroprotective therapies and surfactants, neonatal mortality has decreased, and severe disabilities such as mental retardation, autism, and cerebral palsy have stabilized. This is why low-severity dysfunctions are increased, persist, and worsen throughout school years and in young preterm adults with an impact on quality of life.

Premature birth is associated with a significantly increased risk of infantile and adolescent psychopathology, with social adjustment disorders, compared to full-term birth. These social adjustment disorders are correlated with language disorders and/or dysexecutive syndrome and/or behavioral disorders. Thus, neurobehavioral disorders currently dominate the fate of long-term prematurity. Recently, in the French Epipage 2 cohort, the rates of moderate neurodevelopmental impairment are high (approximately 30%) regardless of gestational age. The persistence and worsening of these neurobehavioral disorders in adulthood for those born preterm (e.g., introverted personality, anxiety disorders) leads to withdrawal and social distancing, making it a public health problem.

Comprehensive research over the past three decades has profiled the neurodevelopmental consequences of preterm birth. Nonetheless, relative to our understanding of the motor and cognitive outcomes, robust conclusions regarding the true nature of childhood psychopathology remain a major challenge, spanning from subclinical to clinical presentations. To a reasonable degree, this ambiguity is due to substantial variability in outcome measures, an over-reliance on single informants, limited longitudinal investigations, and a primary focus on broad mental health classifications rather than individual clinical diagnostic criteria.

The aim of this review is to provide a complete characterization of the neurobehavioral phenotype and to highlight the main gaps in knowledge, mainly with regard to the evolution of symptoms, the co-occurrence of disorders, and associations with chronological age and degree of prematurity. Hypotheses which suggest that this neurobehavioral phenotype of prematurity is due to brain hypo-connectivity, thus leading to diffuse structural abnormalities similar to autism spectrum disorders but with reduced severity, will be discussed based on brain imaging of the newborn term-corrected age. 

Research on preventive interventions, with more individualized approaches capable of mitigating the long-term effects of a premature birth, as well as the identification of risk factors and resilience, will be described. To alleviate mental health problems and parenting disorders leading to impaired brain development which are linked to premature birth, we will talk about the development of “family-centered care” devices in neonatal care and the concept of parental resources with their participation in various projects in partnership with professionals in the field.

To finish we will develop hypotheses on the clinical phenotype of children having presented an encephalopathy anoxo-ischemic to the hypothermia treatment area. 


Dr. Gire Catherine
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • preterm long term outcome
  • neurobehavioural phenotype
  • dysexecutive syndrome
  • neonatal brain imaging
  • development care
  • family-centered care

Published Papers (5 papers)

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Research

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9 pages, 293 KiB  
Article
Classification Performance of the Ages and Stages Questionnaire: Influence of Maternal Education Level
by Marguerite Lockhart, Robin Chaux, Mathilde Chevin, Magali Celle, Tiphaine Raia-Barjat, Hugues Patural, Stéphane Chabrier and Antoine Giraud
Children 2023, 10(3), 449; https://doi.org/10.3390/children10030449 - 25 Feb 2023
Viewed by 1099
Abstract
(1) Background: The Ages and Stages Questionnaire—Third Edition (ASQ-3) is a parental screening questionnaire increasingly being used to evaluate the development of preterm children. We aimed to assess the classification performance of the ASQ-3 in preterm infant follow-up. (2) Methods: In this cross-sectional [...] Read more.
(1) Background: The Ages and Stages Questionnaire—Third Edition (ASQ-3) is a parental screening questionnaire increasingly being used to evaluate the development of preterm children. We aimed to assess the classification performance of the ASQ-3 in preterm infant follow-up. (2) Methods: In this cross-sectional study, we included 185 children from the SEVE longitudinal cohort born <33 weeks of gestational age between November 2011 and January 2018, who had both an ASQ-3 score at 24 months of corrected age (CA) and a revised Brunet–Lézine (RBL) scale score at 30 months of CA. The ASQ-3 overall score and sub-scores were compared to the RBL developmental quotient (DQ) scores domain by domain. The diagnostic performance of the ASQ-3 was evaluated with the RBL as the reference method by calculating sensitivity, specificity, and positive and negative likelihood ratios. A multivariate analysis assessed the association between low maternal education level and incorrect evaluation with the ASQ-3. (3) Results: The ASQ-3 overall score had a specificity of 91%, a sensitivity of 34%, a positive likelihood ratio of 3.82, and a negative likelihood ratio of 0.72. Low maternal education level was a major risk factor for incorrectly evaluating children with the ASQ-3 (odds ratio 4.16, 95% confidence interval 1.47–12.03; p < 0.01). (4) Conclusions: Regarding the low sensitivity and the impact of a low maternal education level on the classification performance of the ASQ-3, this parental questionnaire should not be used alone to follow the development of preterm children Full article
(This article belongs to the Special Issue Neurodevelopmental Disabilities in Neonates)
12 pages, 1328 KiB  
Article
An Updated Overview of MRI Injuries in Neonatal Encephalopathy: LyTONEPAL Cohort
by Jonathan Beck, Gauthier Loron, Pierre-Yves Ancel, Marianne Alison, Lucie Hertz Pannier, Philippe Vo Van, Thierry Debillon and Nathalie Bednarek
Children 2022, 9(4), 561; https://doi.org/10.3390/children9040561 - 14 Apr 2022
Cited by 4 | Viewed by 1995
Abstract
Background: Brain magnetic resonance imaging (MRI) is a key tool for the prognostication of encephalic newborns in the context of hypoxic−ischemic events. The purpose of this study was to finely characterize brain injuries in this context. Methods: We provided a complete, descriptive analysis [...] Read more.
Background: Brain magnetic resonance imaging (MRI) is a key tool for the prognostication of encephalic newborns in the context of hypoxic−ischemic events. The purpose of this study was to finely characterize brain injuries in this context. Methods: We provided a complete, descriptive analysis of the brain MRIs of infants included in the French national, multicentric cohort LyTONEPAL. Results: Among 794 eligible infants, 520 (65.5%) with MRI before 12 days of life, grade II or III encephalopathy and gestational age ≥36 weeks were included. Half of the population had a brain injury (52.4%); MRIs were acquired before 6 days of life among 247 (47.5%) newborns. The basal ganglia (BGT), white matter (WM) and cortex were the three predominant sites of injuries, affecting 33.8% (n = 171), 33.5% (n = 166) and 25.6% (n = 128) of participants, respectively. The thalamus and the periventricular WM were the predominant sublocations. The BGT, posterior limb internal capsule, brainstem and cortical injuries appeared more frequently in the early MRI group than in the late MRI group. Conclusion: This study described an overview of brain injuries in hypoxic−ischemic neonatal encephalopathy. The basal ganglia with the thalamus and the WM with periventricular sublocation injuries were predominant. Comprehensive identification of brain injuries in the context of HIE may provide insight into the mechanism and time of occurrence. Full article
(This article belongs to the Special Issue Neurodevelopmental Disabilities in Neonates)
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12 pages, 734 KiB  
Article
Cardio-Respiratory Events and Food Autonomy Responses to Early Uni-Modal Orofacial Stimulation in Very Premature Babies: A Randomized, Controlled Study
by Sahra Méziane, Véronique Brévaut-Malaty, Aurélie Garbi, Muriel Busuttil, Gaelle Sorin, Barthélémy Tosello and Catherine Gire
Children 2021, 8(12), 1188; https://doi.org/10.3390/children8121188 - 16 Dec 2021
Cited by 1 | Viewed by 1862
Abstract
Uni-modal orofacial stimulation (OFS) for preventing very preterm infants’ oral disorders is highly controversial. Our study sought to demonstrate that OFS reduced cardio-respiratory events and improved food autonomy in a population of very preterm infants. Our study was randomized, controlled, prospective, and unicentric. [...] Read more.
Uni-modal orofacial stimulation (OFS) for preventing very preterm infants’ oral disorders is highly controversial. Our study sought to demonstrate that OFS reduced cardio-respiratory events and improved food autonomy in a population of very preterm infants. Our study was randomized, controlled, prospective, and unicentric. The preterm included were born between 26–29 weeks gestational age (GA) with a corrected postnatal age <33 weeks GA. They were randomized into two groups: the experimental group underwent OFS, according to a protocol established, over 10 consecutive days, and the control group underwent no OFS. The primary outcome was the number of cardiorespiratory events: apnea–bradycardia (with or without desaturations) or number of isolated desaturations, which were evaluated at four separate times. Measurements occurred during the first, fourth and eighth independent feedings. Seventeen patients were included in the experimental group and 18 in the control group. The number of cardiorespiratory events for all independent feeding times was significantly reduced in the OFS group (p = 0.003) with univariate analysis, but not with multivariable analysis. The quantity of milk ingested during the first autonomous feeding was higher in the experimental group. The acquisition of food autonomy and the duration of hospitalization were similar in the two groups. While our study does not affirm that an early unimodal OFS improves premature infants’ cardiorespiratory evolution and/or the acquisition of food autonomy, it does indicate an improved food efficiency during their first autonomous feedings. Full article
(This article belongs to the Special Issue Neurodevelopmental Disabilities in Neonates)
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Review

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17 pages, 1255 KiB  
Review
Advanced Brain Imaging in Preterm Infants: A Narrative Review of Microstructural and Connectomic Disruption
by Philippe Vo Van, Marianne Alison, Baptiste Morel, Jonathan Beck, Nathalie Bednarek, Lucie Hertz-Pannier and Gauthier Loron
Children 2022, 9(3), 356; https://doi.org/10.3390/children9030356 - 04 Mar 2022
Cited by 5 | Viewed by 3220
Abstract
Preterm birth disrupts the in utero environment, preventing the brain from fully developing, thereby causing later cognitive and behavioral disorders. Such cerebral alteration occurs beneath an anatomical scale, and is therefore undetectable by conventional imagery. Prematurity impairs the microstructure and thus the histological [...] Read more.
Preterm birth disrupts the in utero environment, preventing the brain from fully developing, thereby causing later cognitive and behavioral disorders. Such cerebral alteration occurs beneath an anatomical scale, and is therefore undetectable by conventional imagery. Prematurity impairs the microstructure and thus the histological process responsible for the maturation, including the myelination. Cerebral MRI diffusion tensor imaging sequences, based on water’s motion into the brain, allows a representation of this maturation process. Similarly, the brain’s connections become disorganized. The connectome gathers structural and anatomical white matter fibers, as well as functional networks referring to remote brain regions connected one over another. Structural and functional connectivity is illustrated by tractography and functional MRI, respectively. Their organizations consist of core nodes connected by edges. This basic distribution is already established in the fetal brain. It evolves greatly over time but is compromised by prematurity. Finally, cerebral plasticity is nurtured by a lifetime experience at microstructural and macrostructural scales. A preterm birth causes a negative and early disruption, though it can be partly mitigated by positive stimuli based on developmental neonatal care. Full article
(This article belongs to the Special Issue Neurodevelopmental Disabilities in Neonates)
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15 pages, 1813 KiB  
Review
The Neurobehavioral Phenotype of School-Aged, Very Prematurely Born Children with No Serious Neurological Sequelae: A Quality of Life Predictor
by Barthélémy Tosello, Sahra Méziane, Noémie Resseguier, Stéphane Marret, Gilles Cambonie, Meriem Zahed, Véronique Brévaut-Malaty, Any Beltran Anzola, Catherine Gire and for the GPQoL-Study Group
Children 2021, 8(11), 943; https://doi.org/10.3390/children8110943 - 20 Oct 2021
Cited by 5 | Viewed by 1557
Abstract
School-aged extremely preterm (EPT) children have multiple specific neurocognitive/behavioral disorders that are often associated with other disorders; this manifests a true neurobehavioral “phenotype” of prematurity. To determine a profile of cognitive/behavioral impairments in a population of school-aged EPT children (7–10 years-old) without major [...] Read more.
School-aged extremely preterm (EPT) children have multiple specific neurocognitive/behavioral disorders that are often associated with other disorders; this manifests a true neurobehavioral “phenotype” of prematurity. To determine a profile of cognitive/behavioral impairments in a population of school-aged EPT children (7–10 years-old) without major disabilities, a cross-sectional study was conducted in five medical centers. An algorithm distributed the study population according to four WISC-IV subtests, five NEPSY-2 subtests, and two variables of figure of Rey. The behavior (SDQ), anxiety (Spielberg STAI-C), and generic QoL (Kidscreen 10 and VSP-A) were also evaluated. The study included 231 school-aged EPT children. Three neurobehavioral “phenotypes” were defined according to their severity: 1 = moderately, 2 = minor, and 3 = unimpaired. In all the profiles, the working memory, perceptual reasoning, as well as mental flexibility, were close to or below average, and their emotional behavior was always troubled. Self-esteem and school-work were the most impacted QoL areas. The unimpaired neurobehavior exhibited emotional behavioral impairment and executive dysfunction. The profile analysis defined distinct outcome groups and provided an informative means of identifying factors related to developmental outcomes. The QoL deterioration is determined by the severity of the three neurobehavioral “phenotypes”, which is defined as well as by dysexecutive and/or behavioral disorders. Full article
(This article belongs to the Special Issue Neurodevelopmental Disabilities in Neonates)
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