Document Detail


Maternal antenatal complications and the risk of neonatal cerebral white matter damage and later cerebral palsy in children born at an extremely low gestational age.
MedLine Citation:
PMID:  19713285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a 2002-2004 prospective cohort study of deliveries of infants at <28 weeks at 14 US centers, the authors sought the antecedents of white matter damage evident in newborn cranial ultrasound scans (ventriculomegaly and an echolucent lesion) and of cerebral palsy diagnoses at age 2 years. Of the 1,455 infants enrolled, those whose mothers received an antenatal steroid tended to have lower risks of ventriculomegaly and an echolucent lesion than their peers (10% vs. 23%, P < 0.001 and 7% vs. 11%, P = 0.06, respectively). Risk of ventriculomegaly was increased for infants delivered because of preterm labor (adjusted odds ratio (OR) = 2.3, 95% confidence interval (CI): 1.1, 4.9), preterm premature rupture of fetal membranes (OR = 3.6, 95% CI: 1.5, 8.7), and cervical insufficiency (OR = 2.8, 95% CI: 1.4, 5.5) when compared with infants delivered because of preeclampsia. Risk of an echolucent lesion was increased for infants delivered because of preterm labor (OR = 2.7, 95% CI: 1.2, 5.7) and intrauterine growth retardation (OR = 3.3, 95% CI: 1.2, 9.4). The doubling of diparesis risk associated with preterm labor and with preterm premature rupture of fetal membranes did not achieve statistical significance, nor did the doubling of quadriparesis risk and the tripling of diparesis risk associated with cervical insufficiency.
Authors:
Thomas F McElrath; Elizabeth N Allred; Kim A Boggess; Karl Kuban; T Michael O'Shea; Nigel Paneth; Alan Leviton;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2009-08-27
Journal Detail:
Title:  American journal of epidemiology     Volume:  170     ISSN:  1476-6256     ISO Abbreviation:  Am. J. Epidemiol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-23     Completed Date:  2009-10-06     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  7910653     Medline TA:  Am J Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  819-28     Citation Subset:  IM    
Affiliation:
Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. tmcelrath@partners.org
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MeSH Terms
Descriptor/Qualifier:
Cerebral Palsy / epidemiology*
Cerebral Ventricles / abnormalities
Female
Fetal Growth Retardation
Humans
Infant, Newborn
Infant, Premature*
Leukomalacia, Periventricular / epidemiology*,  ultrasonography
Male
Multivariate Analysis
Obstetric Labor Complications / epidemiology
Pre-Eclampsia / epidemiology
Pregnancy
Pregnancy Complications / epidemiology*
Prospective Studies
Risk
United States / epidemiology
Uterine Cervical Incompetence / epidemiology
Grant Support
ID/Acronym/Agency:
K12 HD01255/HD/NICHD NIH HHS; U01 NS 400069-01/NS/NINDS NIH HHS
Investigator
Investigator/Affiliation:
Bhavesh Shah / ; Solveg Pflueger / ; Glenn Markenson / ; Camilia R Martin / ; Jonathon L Hecht / ; Bruce Cohen / ; Linda J Van Marter / ; Harvey Kliman / ; Thomas F McElrath / ; Alan Leviton / ; Robert Insoft / ; Drucilla Roberts / ; Laura Riley / ; Cynthia Cole / ; John Fiascone / ; Ina Bhan / ; Sabrina Craigo / ; Theresa Marino / ; Francis Bednarek / ; Gamze Ayata / ; Ellen Delpapa / ; Richard Ehrenkranz / ; Miguel Reyes-Múgica / ; Eduardo Zambrano / ; Keith P Williams / ; T Michael O'Shea / ; Dennis W Ross / ; Maggie Harper / ; Stephen Engelke / ; John Christie / ; Hamid Hadi / ; Carl Bose / ; Chad Livasy / ; Kim Boggess / ; Mariel Portenga / ; Barbara Doss / ; Curtis Cook / ; Padmani Karna / ; Gabriel Chamyan / ; Steve Roth / ; Michael D Schreiber / ; Aliya Husain / ; Mahmoud Ismail / ; Daniel Batton / ; Chung-Ho Chang / ; Robert Lorenz /
Comments/Corrections

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