Netanel Agajany1, Moran Gigi1, Jessica Ross1, Jonathan Roth2, Rina Eshel2, Shlomi Constantini2, Haim Bassan3. 1. Pediatric Neurology & Development Center, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel. 2. Department of Pediatric Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, both affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Pediatric Neurology & Development Center, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel. Electronic address: bassan@tauex.tau.ac.il.
Abstract
AIMS: To determine the impact on families (IOF) of former preterm infants (gestational age < 32 weeks) after posthemorrhagic hydrocephalus requiring shunt (PHH-S), and to identify risk factors of family dysfunction. STUDY DESIGN: 38 preterm infants with PHH-S were matched for gestational age, birthweight, and gender with preterm infants with normal cranial ultrasonography. IOF questionnaire was administered at 5.7 ± 2 years (higher IOF score indicates worse impact). RESULTS: Families of PHH-S children exhibited significantly worse IOF compared to controls in financial (9.2 ± 2.2 vs 5.9 ± 1.4), family-personal (26.6 ± 5.2 vs 20.2 ± 2.8), and disruptive social (21.4 ± 4.9 vs 16.7 ± 3.1) domains (P < 0.001). Multivariate regression incorporating neonatal risk factors revealed an independent effect of parenchymal brain involvement (β:0.4, P:0.002) and neonatal seizures (β:0.3, p:0.007) on total IOF. Neurosensory morbidity was significantly higher in the PHH-S group, including cerebral palsy (81.6%), epilepsy (47.4%), problems with vision (63.2%), feeding (39.5%) and hearing (18.4%), chronic health problems (44.7%) and hospital admissions in the last 6 months (44.7%). Worse IOF scores of PHH-S families were associated with socioeconomic status and neurodevelopmental morbidities: cerebral palsy severity, feeding problems, number of neurosurgeries, low cognitive, personal-social, and adaptive scores (P < 0.05). Multivariate analysis indicated an independent contribution from cerebral palsy severity (β:0.5, p:0.002) and socioeconomic status (β:-0.4, P: 0.01). CONCLUSIONS: Families of preterm children after PHH-S exhibit significantly worse IOF scores compared to families of preterm peers. Worse IOF is associated with severe hemorrhage, neurodevelopmental morbidities and socioeconomic status. A family centered intervention is warranted after PHH-S.
AIMS: To determine the impact on families (IOF) of former preterm infants (gestational age < 32 weeks) after posthemorrhagic hydrocephalus requiring shunt (PHH-S), and to identify risk factors of family dysfunction. STUDY DESIGN: 38 preterm infants with PHH-S were matched for gestational age, birthweight, and gender with preterm infants with normal cranial ultrasonography. IOF questionnaire was administered at 5.7 ± 2 years (higher IOF score indicates worse impact). RESULTS: Families of PHH-Schildren exhibited significantly worse IOF compared to controls in financial (9.2 ± 2.2 vs 5.9 ± 1.4), family-personal (26.6 ± 5.2 vs 20.2 ± 2.8), and disruptive social (21.4 ± 4.9 vs 16.7 ± 3.1) domains (P < 0.001). Multivariate regression incorporating neonatal risk factors revealed an independent effect of parenchymal brain involvement (β:0.4, P:0.002) and neonatal seizures (β:0.3, p:0.007) on total IOF. Neurosensory morbidity was significantly higher in the PHH-S group, including cerebral palsy (81.6%), epilepsy (47.4%), problems with vision (63.2%), feeding (39.5%) and hearing (18.4%), chronic health problems (44.7%) and hospital admissions in the last 6 months (44.7%). Worse IOF scores of PHH-S families were associated with socioeconomic status and neurodevelopmental morbidities: cerebral palsy severity, feeding problems, number of neurosurgeries, low cognitive, personal-social, and adaptive scores (P < 0.05). Multivariate analysis indicated an independent contribution from cerebral palsy severity (β:0.5, p:0.002) and socioeconomic status (β:-0.4, P: 0.01). CONCLUSIONS: Families of preterm children after PHH-S exhibit significantly worse IOF scores compared to families of preterm peers. Worse IOF is associated with severe hemorrhage, neurodevelopmental morbidities and socioeconomic status. A family centered intervention is warranted after PHH-S.
Authors: Linda S Franck; Renée A Shellhaas; Monica E Lemmon; Julie Sturza; Marty Barnes; Trisha Brogi; Elizabeth Hill; Katrina Moline; Janet S Soul; Taeun Chang; Courtney J Wusthoff; Catherine J Chu; Shavonne L Massey; Nicholas S Abend; Cameron Thomas; Elizabeth E Rogers; Charles E McCulloch; Hannah C Glass Journal: Children (Basel) Date: 2021-12-22