Document Detail


Association of prematurity and neonatal infection with neurologic morbidity in very low birth weight infants.
MedLine Citation:
PMID:  12798532     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify risk factors predictive of neurologic morbidity in very low birth weight (VLBW) infants. METHODS: This is a case-control study of all infants weighing 1500 g or less admitted to a single tertiary neonatal intensive care unit between April 1999 and December 2001. The case group were those neonates with neurologic morbidity including intraventricular hemorrhage, seizures, hydrocephalus, and periventricular leukomalacia. The control group were those without neurologic morbidity. Wilcoxon rank-sum, Fisher exact test, chi(2), and univariate and stepwise multiple logistic regression were performed, with P < 0.05 considered significant. RESULTS: Of 213 VLBW infants, 77 had neurologic morbidity: 61 had intraventricular hemorrhage, eight had seizures, 13 had hydrocephalus, and nine had periventricular leukomalacia. Several infants had more than one morbidity. Gestational age (odds ratio [OR] 0.95; 95% confidence interval [CI] 0.94, 0.96; P <.005), birth weight (OR 0.62; 95% CI 0.49, 0.79; P <.005), and neonatal infection (OR 1.36; 95% CI 1.17, 1.58; P <.005) were highly associated with neurologic morbidity. There was no difference in mean umbilical arterial cord pH (7.25 +/- 0.15, 7.28 +/- 0.09, P =.45) or base excess (-3.8 +/- 4.8 mEq/L, -2.3 +/- 3.0, P =.10). Only three of 52 infants (5.8%) in the case group had an umbilical arterial pH of less than 7. CONCLUSION: Prematurity and neonatal infection were the dominant factors associated with neurologic morbidity in VLBW infants. Intrapartum acidosis occurred in less than 6% of those with neurologic morbidity.
Authors:
Cynthia J Holcroft; Karin J Blakemore; Marilee Allen; Ernest M Graham
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  101     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-11     Completed Date:  2003-07-03     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1249-53     Citation Subset:  AIM; IM    
Affiliation:
Department of Gynecology-Obstetrics, Johns Hopkins University School of Medicine, Baltimore 21287, Maryland, USA. cholcroft@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain Diseases / etiology*
Case-Control Studies
Chorioamnionitis / complications*
Female
Fetal Blood / chemistry
Fetal Hypoxia / complications
Humans
Hydrocephalus / etiology
Hydrogen-Ion Concentration
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / etiology*
Infant, Very Low Birth Weight*
Infection / complications*
Intracranial Hemorrhages / etiology
Leukomalacia, Periventricular / etiology
Logistic Models
Male
Pregnancy
Risk Factors
Seizures / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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