The Neurobehavioral Phenotype of School-Aged, Very Prematurely Born Children with No Serious Neurological Sequelae: A Quality of Life Predictor
Barthélémy Tosello,
Sahra Méziane,
Noémie Resseguier,
Stéphane Marret,
Gilles Cambonie,
Meriem Zahed,
Véronique Brévaut-Malaty,
Any Beltran Anzola,
Catherine Gire,
for the GPQoL-Study Group
Affiliations
Barthélémy Tosello
Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrely, CEDEX 20, 13915 Marseille, France
Sahra Méziane
Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrely, CEDEX 20, 13915 Marseille, France
Noémie Resseguier
CEReSS-Health Service Research and Quality of Life Center, Faculty of Medicine, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
Stéphane Marret
Department of Neonatal Medicine, Neuropediatrics Rouen University Hospital and INSERM U 1245, Neovasc Team, Perinatal Neurological Handicap and Neuroprotection IRIB, School of Medicine, Rouen University, 1 rue de Germont, CEDEX, 76031 Rouen, France
Gilles Cambonie
Department of Neonatal Medicine, Montpellier University Hospital, 191 av. du Doyen Giraud, CEDEX 5, 34295 Montpellier, France
Meriem Zahed
Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrely, CEDEX 20, 13915 Marseille, France
Véronique Brévaut-Malaty
Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrely, CEDEX 20, 13915 Marseille, France
Any Beltran Anzola
Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrely, CEDEX 20, 13915 Marseille, France
Catherine Gire
Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrely, CEDEX 20, 13915 Marseille, France
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.
