Neurodevelopmental outcomes of premature infants with severe intraventricular hemorrhage

Çalışıcı, Erhan; Eras, Zeynep; Öncel, Mehmet Yekta; Oğuz, Şerife Suna; Gökçe, İsmail Kürşat; Dilmen, Uğur

doi:10.3109/14767058.2014.979783

Cited by 42 publications

(28 citation statements)

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“…IVH, PVL, BPD, NEC, sepsis, and ROP have all been associated with neurodevelopmental impairment. [26][27][28][29][30] Other studies have shown higher rates of cerebral palsy, cognitive impairment, and behavioral problems among those born at very early gestations, 31-34 thus putting extremely preterm infants with major neonatal morbidities at high risk for significant impairment later in life.…”

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confidence: 99%

“…11 Although populationbased data are available for some countries, 1,4,5 comparable data in the United States are limited. 13,20 The primary aim of the present study was to assess the rates of mortality and major morbidity among extremely preterm infants (22)(23)(24)(25)(26)(27)(28) weeks' gestation) born in California, by using data collected from 2007 through 2011 by the California Office of Statewide Health Planning and Development (OSHPD). We also examined the rates of neonatal interventions and timing of death for each gestational week between 22 and 28 weeks.…”

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Survival and Major Morbidity of Extremely Preterm Infants: A Population-Based Study

et al. 2016

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OBJECTIVES: To assess the rates of mortality and major morbidity among extremely preterm infants born in California and to examine the rates of neonatal interventions and timing of death at each gestational age. METHODS:A retrospective cohort study of all California live births from 2007 through 2011 linked to vital statistics and hospital discharge records, whose best-estimated gestational age at birth was 22 through 28 weeks. Major morbidities were based on International Classification of Diseases, Ninth Revision, Clinical Modification codes. Survival beyond the first calendar day of life and procedure codes were used to assess attempted resuscitation after birth. RESULTS:A total of 6009 infants born at 22 through 28 weeks' gestation were included. Survival to 1 year for all live births ranged from 6% at 22 weeks to 94% at 28 weeks. Seventy-three percent of deaths occurred within the first week of life. Major morbidity was present in 80% of all infants, and multiple major morbidities were present in 66% of 22-and 23-week infants. Rates of resuscitation at 22, 23, and 24 weeks were 21%, 64%, and 93%, respectively. Survival after resuscitation was 31%, 42%, and 64% among 22-, 23-, and 24-week infants, respectively. Improved survival was associated with increased birth weight, female sex, and cesarean delivery (P < .01) for resuscitated 22-, 23-, and 24-week infants. CONCLUSIONS:In a population-based study of extreme prematurity, infants ≤24 weeks' gestation are at highest risk of death or major morbidity. These data can help inform recommendations and decision-making for extremely preterm births.

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confidence: 99%

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Survival and Major Morbidity of Extremely Preterm Infants: A Population-Based Study

et al. 2016

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“…These patient characteristics and short-term clinical outcomes were chosen because of their established adverse effect on the primary outcome of this study, i.e. long-term neurodevelopmental outcome [18,19,20,21]. We did not correct for cystic periventricular leukomalacia (cPVL) since the incidence of this outcome was extremely low in both groups.…”

Section: Methodsmentioning

confidence: 99%

Long-Term Neurodevelopmental Outcome after Doxapram for Apnea of Prematurity

Hove

Vliegenthart²,

Pas³

et al. 2016

Neonatology

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Background: Doxapram has been advocated as a treatment for persistent apnea of prematurity (AOP). Objective: To evaluate the effect of doxapram on long-term neurodevelopmental outcome in preterm infants as its safety still needs to be established. Methods: From a retrospective cohort of preterm infants with a gestational age (GA) <30 weeks and/or a birth weight <1,250 g, born between 2000 and 2010, infants treated with doxapram (n = 142) and a nontreated control group were selected (n = 284). Patient characteristics and clinical and neurodevelopmental outcome data at 24 months' corrected age were collected. Neurodevelopmental delay (ND) was defined as having a Mental or Psychomotor Developmental Index (MDI/PDI) <-1 standard deviation (SD), cerebral palsy, or a hearing or visual impairment. Odds ratios (OR) were calculated using multiple logistic regression analyses adjusting for potential confounders. Results: Infants treated with doxapram had a lower GA compared to controls. The number of infants with a MDI or PDI <-1 SD was not different between the groups. The risk of the combined outcome death or ND was significantly lower in the doxapram group after adjusting for confounding factors (OR = 0.54, 95% CI: 0.37, 0.78). Doxapram-treated infants had a higher risk of bronchopulmonary dysplasia and patent ductus arteriosus, but a lower risk of spontaneous intestinal perforation. All other morbidities were not different between the groups. Conclusions: This study suggests that doxapram is not associated with an increased risk of ND. These findings need to be confirmed or refuted by a large, well-designed, placebo-controlled randomized trial.

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“…Several studies have shown the negative impact of severe IVH on mortality and neurodevelopmental outcome of affected patients [8,9], but there is no agreement about the impact of low-grade IVH. Although data from large population studies suggest that preterm infants with IVH grades I and II are not at risk for longterm neurodevelopmental impairment [10,11], other studies indicate that this population is vulnerable to poor outcome [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Low-grade intraventricular hemorrhage and neurodevelopment at 24 months of age

Peixoto

Amaral

Resende

et al. 2018

Sci Med

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AIMS: To evaluate the impact of low-grade intraventricular hemorrhage on neurodevelopmental outcome in preterm infants at 24 months of age. METHODS: We conducted a retrospective case-control study of infants with gestational age less than 34 weeks, admitted to a Neonatal Intensive Care Unit between January/2006 and December/2015. Cases were defined as those with low-grade intraventricular hemorrhage (grades I or II), diagnosed by cranial ultrasonography. For each case, a control with the same gestational age but without intraventricular hemorrhage was selected. Follow-up examinations of neurodevelopment were performed at 24 months of age in cases and controls using the Griffiths Mental Development Scale. Cerebral palsy, neurodevelopmental delay (developmental quotient <2 side deviations below the mean), hearing impairment and/or blindness were considered as severe neurodevelopmental impairment. RESULTS: The study included 172 preterm infants: 86 cases and 86 controls. In the univariate analysis, a difference between the two groups was identified for the following clinical findings: antenatal corticosteroid complete cycle (57% in cases vs. 80% in controls; p=0.001; OR: 0.33, 95%CI 0.17-0.64); male gender (63% cases vs. 41% controls; p=0.004; OR: 2.45, 95%CI 1.3-4.5); outborn (26% cases vs. 9% controls; p=0.005; OR: 3.3 95%CI 1.4-8.0); Clinical Risk Index for Babies higher than 5 (24% in cases vs. 12% in controls; p=0.029; OR: 2.4 95%CI 1.1-5.6); intubation in the delivery room (47% cases vs. 27% controls; p=0.007; OR: 2.38 95%CI 1.3-4.5); and neonatal sepsis (34% in cases vs. 20% in controls; p=0.039; OR: 2.1 95%CI 1.03-4.1). After logistic regression, differences were only maintained for antenatal corticosteroid (p=0.005; OR 0.34, 95%CI 0.16-0.72) and male gender (p=0.002; OR 2.9, 95%CI 1.4-5.8). A severe neurodevelopmental deficit was present in three cases (3.5%) and one control (1.2%). No statistically significant differences in outcome were found between cases and controls. CONCLUSIONS: In this sample, preterm infants with low-grade intraventricular hemorrhage diagnosed by cranial ultrasonography had no difference in early neurodevelopmental outcome when compared with controls.KEYWORDS: cerebral intraventricular hemorrhage; preterm infant; neurodevelopmental disorders. RESUMOOBJETIVOS: Avaliar o impacto da hemorragia intraventricular de baixo grau no neurodesenvolvimento de lactentes prematuros aos 24 meses de idade. MÉTODOS: Foi conduzido um estudo de caso-controle retrospectivo em lactentes com idade gestacional inferior a 34 semanas, internados em uma Unidade de Terapia Intensiva Neonatal entre janeiro de 2006 e dezembro de 2015. Os casos foram definidos como aqueles com hemorragia intraventricular de baixo grau (graus I ou II), diagnosticada por ultrassonografia craniana. Para cada caso, foi selecionado um controle com a mesma idade gestacional, mas sem hemorragia intraventricular. A avaliação do neurodesenvolvimento foi realizada aos 24 meses de idade, em casos e controles, com a Escala de Desen...

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Neurodevelopmental outcomes of premature infants with severe intraventricular hemorrhage

Cited by 42 publications

References 28 publications

Survival and Major Morbidity of Extremely Preterm Infants: A Population-Based Study

Survival and Major Morbidity of Extremely Preterm Infants: A Population-Based Study

Long-Term Neurodevelopmental Outcome after Doxapram for Apnea of Prematurity

Low-grade intraventricular hemorrhage and neurodevelopment at 24 months of age

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