Functional development at school age of newborn infants at risk

PhD ceremony: Ms. E. Roze, 12.45 uur, Aula Academiegebouw, Broerstraat 5, Groningen

Dissertation: Functional development at school age of newborn infants at risk

Promotor(s): prof. A.F. Bos

Faculty: Medical Sciences

This thesis deals with the functional development at school age of newborn infants with perinatal risk factors for adverse outcome. We showed for the first time that the transplacental transfer of brominated flame retardants is associated with the motor, cognitive, and behavioral outcome of healthy newborn infants. Because of the widespread use of these compounds we concluded that these results are a cause of serious concern. In addition we found that in preterm children with periventricular hemorrhagic infarction, the majority had cerebral palsy with limited functional impairment at school age. We concluded that the functional outcome at school age of preterm children with this brain lesion was better than previously thought. In contrast, in infants with systemic disease in the neonatal period such as necrotizing enterocolitis and late-onset sepsis, we found that the outcome at school age was worse than one would expect. Their intelligence, for example, was barely better compared to preterm children with severe brain lesions. The pathophysiological mechanisms responsible for the functional impairments that we found at school age are complex and multifactorial. In preterm born infants white matter damage to the brain as a result of neuroinflammation plays a prominent role. We recommend to include measures of motor, intellectual, neuropsychological and behavioral functioning in a follow-up program. Adequate follow-up of newborn infants could lead to the early identification of functional impairments so as to identify opportunities for early intervention.