| Effect of inborn vs. outborn delivery on neurodevelopmental outcomes in infants with hypoxic-ischemic encephalopathy: secondary analyses of the NICHD whole-body cooling trial. | |
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MedLine Citation:
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PMID: 22914450 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background:The effect of birth location on hypothermia-related outcomes has not been rigorously examined in the literature. In this study, we determined whether birth location had an impact on the benefits of whole-body cooling to 33.5 °C for 72 h in term infants (n = 208) with hypoxic-ischemic encephalopathy (HIE) who participated in the Neonatal Research Network (NRN) randomized controlled trial.Methods:Heterogeneity by birth location was examined with respect to cooling treatment for the 18-mo primary outcomes (death, moderate disability, severe disability) and secondary outcomes (death, components of disability), and in-hospital organ dysfunction. Logistic regression models were used to generate adjusted odds ratios.Results:Infants born at a location other than an NRN center (outborn) (n = 93) experienced significant delays in initiation of therapy (mean (SD): 5.5 (1.1) vs. 4.4 (1.2) h), lower baseline temperatures (36.6 (1.2) vs. 37.1 (0.9) °C), and more severe HIE (43 vs. 29%) than infants born in an NRN center (inborn) (n = 115). Maternal education <12 y (50 vs. 14%) and African-American ethnicity (43 vs. 25%) were more common in the inborn group. When adjusted for NRN center and HIE severity, there were no significant differences in 18-mo outcomes or in-hospital organ dysfunction between inborn and outborn infants.Conclusion:Although limited by sample size and some differences in baseline characteristics, the study showed that birth location does not appear to modify the treatment effect of hypothermia after HIE. |
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Authors:
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Girija Natarajan; Athina Pappas; Seetha Shankaran; Abbot R Laptook; Michele Walsh; Scott A McDonald; Richard A Ehrenkranz; Jon E Tyson; Ronald N Goldberg; Rebecca Bara; Rosemary D Higgins; Abhik Das; Breda Munoz |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-25 |
Journal Detail:
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Title: Pediatric research Volume: - ISSN: 1530-0447 ISO Abbreviation: Pediatr. Res. Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-8-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0100714 Medline TA: Pediatr Res Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Pediatrics, Wayne State University, Detroit, Michigan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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