NICU Follow Up and Neurodevelopment 4: Very Long and Long Term Follow-Up
Nathalie Charpak, MD (she/her/hers)
Bogota, Distrito Capital de Bogota, Colombia
178 subjects were included; 97 with KMC and 81 controls. We performed multivariate linear regressions of white matter structures, adjusting for the intervention (KMC days), perinatal illness, and the NHPT result (fine motricity and coordination). The correlation between NHPT and the length of the fibers of the full Corpus Callosum (CC) was -0,34 (p< 0,01) and with the cerebellum WM volume -0,22 (p< 0,03). We found differences in the length and organization (Fractional Anisotropy) of the full CC fibers and its central part, according to KMC duration and controlling for perinatal severity index and NHPT results. The adjusted volume of corticospinal tracts was also higher in the KMC group with a positive association with the intensity of the hand motor pinch and a negative association with the latency of apparition of the motor potential.
Conclusion(s): results showed the protective effect of KMC on the organization of the white matter and on corticomotor tract volume. This effect was dose-dependent. The R2 of these lineal regressions was between 10 and 20%, but it is important to take into account that we are 20 years after the intervention. KMC in our initial RCT was applied as a “therapeutic” intervention, at home discharge. With these results and those of recent studies showing a decrease in mortality with immediate continuous KMC, we cannot avoid anymore the use of the KP as soon as possible and as long as possible, considering it a “brain surfactant”.