Document Detail


Mid- and long-term outcome of extremely low birth weight (ELBW) infants: an analysis of prognostic factors.
MedLine Citation:
PMID:  17674256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate morbidity and long-term neurological outcome in a group of extremely low birth weight infants (ELBW; <1000 g) and to correlate the neurological outcome in a small group of intrauterine growth retarded (IUGR) infants with Doppler indices in the umbilical artery. METHODS: One hundred and eighty-three live births with birth weight <1000 g and gestational age < or=34 weeks were included in the study. Neonatal mortality and morbidity were evaluated. At 24 months of corrected age an evaluation of the neurological development of the children was made by pediatric neuropsychiatrists. The children were classified as: normal, with minor neurological sequelae, and with major neurological sequelae. The evaluation of umbilical artery velocimetry was applied to 84 fetuses presenting with IUGR and the velocimetric patterns were correlated with neurological outcome. RESULTS: In the 183 infants discharged from the Department of Neonatology, respiratory distress syndrome (RDS) was the most frequent pathology (76.6%); less frequent were bronchopulmonary dysplasia (BPD; 19.5%), patent ductus arteriosus (PDA; 29.7%) and necrotizing enterocolitis (NEC; 5.5%). Retinopathy of prematurity (ROP) affected 34 children (26.6%), and 14.8% of the children developed intraventricular hemorrhage (IVH) and 14.1% periventricular leukomalacia (PVL). Out of the 183 infants included in the study, 107 had a neurological assessment at two years: 22 (20.6%) suffered from severe neurological sequelae, 20 (18.7%) from minor neurological sequelae, and 65 (60.7%) had a normal neurological development. In 84 IUGR fetuses a Doppler evaluation of the umbilical artery was performed: the incidence of neurologically normal children was 67% in the group with normal umbilical velocimetry, 93% in the group with increased umbilical resistances, and 59% in those with absent or reversed end-diastolic velocity (ARED). CONCLUSIONS: This study, confirms that an extremely low birth weight implies a high risk of perinatal mortality and neonatal morbidity, but that the most significant variable that can be correlated to the long-term neurological outcome is the gestational age.
Authors:
A Valcamonico; P Accorsi; C Sanzeni; P Martelli; P La Boria; A Cavazza; T Frusca
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  20     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-08-03     Completed Date:  2007-08-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465-71     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Università di Brescia, Italy. a.valcamonico@libero.it
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Bronchopulmonary Dysplasia / epidemiology
Cerebral Hemorrhage / epidemiology
Ductus Arteriosus, Patent / epidemiology
Enterocolitis, Necrotizing / epidemiology
Fetal Growth Retardation / physiopathology
Follow-Up Studies
Gestational Age
Humans
Infant Mortality
Infant, Extremely Low Birth Weight*
Infant, Newborn
Infant, Premature, Diseases / epidemiology
Laser-Doppler Flowmetry
Leukomalacia, Periventricular / epidemiology
Morbidity
Nervous System Diseases / epidemiology*
Prognosis
Respiratory Distress Syndrome, Newborn / epidemiology
Retinopathy of Prematurity / epidemiology
Umbilical Arteries / physiopathology

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


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