INS NYC 2024 Program

Poster	Poster Session 03 Program Schedule 02/15/2024 09:30 am - 10:40 am Room: Shubert Complex (Posters 1-60) Poster Session 03: Neurotrauma \| Neurovascular Final Abstract #57 Umbilical Cord Blood Gas and Acid-Base Analysis: Associations with Motor and Language Outcome in Preterm-Born Preschoolers Christina Dandar, Wayne State University, Detroit, United States Jamie Piercy, University of British Columbia-Okanagan, Kelowna, Canada Andrew Heitzer, St. Jude Children's Research Hospital, Memphis, United States Allyssa Mattes, University of Michigan, Ann Arbor, United States Brittany Paul, Nashville Neuropsychology and Family Services, Nashville, United States Emma Gimenez DeGeorge, Wayne State University, Detroit, United States Christina Lee, Wayne State University, Detroit, United States Judith Klarr, William Beaumont Hospital, Royal Oak, United States Sarah Raz, Wayne State University, Detroit, United States Category: Anoxia/Hypoxia Keyword 1: perinatal factors Keyword 2: language: development Keyword 3: prematurity Objective: Preterm -birth is associated with increased risk for hypoxic-ischemic brain injury. Early biochemical indices associated with hypoxia-ischemia include arterial cord pH, carbon dioxide (pCO₂), and base deficit (BD). In the current study we attempted to establish dose-response relationships between each of these biochemical indices and outcome at preschool-age. We focused on two important outcome domains: motor skills and language functions. Participants and Methods: Results of umbilical cord blood-gas analysis were available from medical records of 163 preterm-born (< 34 weeks gestation) children who were evaluated at preschool age. Motor and language skills were assessed between 3-4 years of age. The participants (85 females; 78 males) were graduates of the Neonatal Intensive Care Unit at William Beaumont Hospital (WBH), Royal Oak, MI. Gross and fine motor skills were assessed with the Peabody Developmental Motor Scales – Second Edition (PDMS-2). Expressive and receptive language skills were assessed with the Clinical Evaluation of Language Fundamentals – Preschool, 2^nd Edition (CELF-P2). Children with congenital anomalies, history of moderate to severe perinatal intracranial pathology, cerebral palsy, or seizure disorder, were excluded. Results: We conducted separate mixed model linear regression analyses using the PDMS-2 Gross Motor Quotient (GMQ) and Fine Motor Quotient (FMQ), as well as the CELF-P2 Expressive Language Index (ELI) and Receptive Language Index (RLI), as dependent variables. The biochemical measures obtained from arterial cord blood were our variables of interest. We statistically adjusted for sociodemographic factors (SES and sex) as well as perinatal risk (gestational age, standardized birth weight, and sum of antenatal complications). The results of analyses of motor performance revealed that arterial cord pH was significantly associated with the GMQ (t(1,146) = 2.09; p =.038), but not the FMQ (t(1,148) = 1.06; p =.292). Correspondingly, arterial cord pCO₂was significantly associated with the GMQ (t(1,146) = -2.21; p = .029), but not the FMQ (t(1,150) = -1.45; p = .148). Analyses of language functioning revealed that arterial cord pH was associated with the ELI (t(1,141) = 2.24; p = .027) but not the RLI (t(1,142) = 1.28; p = .203). The relationship between arterial pCO₂and ELI scores approximated statistical significance (t(1,141) = -1.79; p = .076), whereas the association between pCO₂and the RLI was nonsignificant (t(1,142) = -1.04; p = .30). Arterial cord BD was not significantly associated with outcome measures. Conclusions: In a high-risk sample of nonhandicapped, preterm-born, preschoolers we demonstrated dose-response relationships between perinatal indices linked to hypoxia-ischemia and both gross motor and expressive language functioning. Together, the findings suggest that increasing levels of acidemia and hypercapnia (hypercarbia), measured in arterial cord blood of preterm neonates shortly after delivery, are associated with increasing vulnerability to poorer motor and language outcome even in the absence of observable perinatal neurological insult or subsequent neurological impairment.

Poster

02/15/2024
09:30 am - 10:40 am
Room: Shubert Complex (Posters 1-60)

Poster Session 03: Neurotrauma | Neurovascular

Final Abstract #57

Umbilical Cord Blood Gas and Acid-Base Analysis: Associations with Motor and Language Outcome in Preterm-Born Preschoolers

Christina Dandar, Wayne State University, Detroit, United States
Jamie Piercy, University of British Columbia-Okanagan, Kelowna, Canada
Andrew Heitzer, St. Jude Children's Research Hospital, Memphis, United States
Allyssa Mattes, University of Michigan, Ann Arbor, United States
Brittany Paul, Nashville Neuropsychology and Family Services, Nashville, United States
Emma Gimenez DeGeorge, Wayne State University, Detroit, United States
Christina Lee, Wayne State University, Detroit, United States
Judith Klarr, William Beaumont Hospital, Royal Oak, United States
Sarah Raz, Wayne State University, Detroit, United States

Category: Anoxia/Hypoxia

Keyword 1: perinatal factors
Keyword 2: language: development
Keyword 3: prematurity

Objective:

Preterm -birth is associated with increased risk for hypoxic-ischemic brain injury. Early biochemical indices associated with hypoxia-ischemia include arterial cord pH, carbon dioxide (pCO₂), and base deficit (BD). In the current study we attempted to establish dose-response relationships between each of these biochemical indices and outcome at preschool-age. We focused on two important outcome domains: motor skills and language functions.

Participants and Methods:

Results of umbilical cord blood-gas analysis were available from medical records of 163 preterm-born (< 34 weeks gestation) children who were evaluated at preschool age. Motor and language skills were assessed between 3-4 years of age. The participants (85 females; 78 males) were graduates of the Neonatal Intensive Care Unit at William Beaumont Hospital (WBH), Royal Oak, MI. Gross and fine motor skills were assessed with the Peabody Developmental Motor Scales – Second Edition (PDMS-2). Expressive and receptive language skills were assessed with the Clinical Evaluation of Language Fundamentals – Preschool, 2^nd Edition (CELF-P2). Children with congenital anomalies, history of moderate to severe perinatal intracranial pathology, cerebral palsy, or seizure disorder, were excluded.

Results:

We conducted separate mixed model linear regression analyses using the PDMS-2 Gross Motor Quotient (GMQ) and Fine Motor Quotient (FMQ), as well as the CELF-P2 Expressive Language Index (ELI) and Receptive Language Index (RLI), as dependent variables. The biochemical measures obtained from arterial cord blood were our variables of interest. We statistically adjusted for sociodemographic factors (SES and sex) as well as perinatal risk (gestational age, standardized birth weight, and sum of antenatal complications). The results of analyses of motor performance revealed that arterial cord pH was significantly associated with the GMQ (t(1,146) = 2.09; p =.038), but not the FMQ (t(1,148) = 1.06; p =.292). Correspondingly, arterial cord pCO₂was significantly associated with the GMQ (t(1,146) = -2.21; p = .029), but not the FMQ (t(1,150) = -1.45; p = .148). Analyses of language functioning revealed that arterial cord pH was associated with the ELI (t(1,141) = 2.24; p = .027) but not the RLI (t(1,142) = 1.28; p = .203). The relationship between arterial pCO₂and ELI scores approximated statistical significance (t(1,141) = -1.79; p = .076), whereas the association between pCO₂and the RLI was nonsignificant (t(1,142) = -1.04; p = .30). Arterial cord BD was not significantly associated with outcome measures.

Conclusions:

In a high-risk sample of nonhandicapped, preterm-born, preschoolers we demonstrated dose-response relationships between perinatal indices linked to hypoxia-ischemia and both gross motor and expressive language functioning. Together, the findings suggest that increasing levels of acidemia and hypercapnia (hypercarbia), measured in arterial cord blood of preterm neonates shortly after delivery, are associated with increasing vulnerability to poorer motor and language outcome even in the absence of observable perinatal neurological insult or subsequent neurological impairment.