Neurodevelopmental Outcome at Preschool Age 38-months and Full-Scale Intelligence Quotient Evaluation at Age 7.2-years: In Children Treated for Persistent Pulmonary Hypertension of Newborn

Abstract

Background: There is lack of literature on long-term neurodevelopmental outcome in children who have survived persistent pulmonary hypertension of newborn (PPHN). Objective: To evaluate neurodevelopmental outcomes at preschool age 38 months and subsequently, assess full scale intelligence quotient (FSIQ) at 86 months in children post therapy for severe PPHN. Methods: Study of 81 children successfully treated with high frequency oscillatory ventilation, exogenous surfactant, inhaled nitric oxide (n=37) and intragastric sildenafil (n=44) for severe PPHN. Developmental assessment was performed at age 38 months with Bayley Scales of Infant and Toddler Development–Third EditionUK (Bayley-III). Intellectual ability was evaluated at age 86 months with Wechsler Intelligence Scale for Children-Fourth EditionUK (WISC-IV FSIQ). Composite scores are presented as mean with standard deviation (SD) in parenthesis. Results: Bayley-III scores in sixty-six (81%) children at age 38 months, for developmental domains were between 106 and 114 (normal: ≥ 85). Ten percent had mild neurological impairment (70-84) and 9% showed moderate to severe delay (55 -69). Neurologically normal children (81%) at age 86 months scored either average (90-109) or high-average (110-119) with WISC-IV. FSIQ was 112.09 (13.20). Mild severity of neurological disability occurred in 10% with FSIQ: 64.19 (8.79). Moderate severity of impairment was observed in 9% with FSIQ: 46.44 (8.52). Conclusions: Qualitatively, eighty-one percent of neurologically normal children at age 7.2 years showed average to high-average intelligence. Incidence of normal neurological development and intelligence quotient was 81% in children treated for severe PPHN