Document Detail

Neonatal antecedents for cerebral palsy in extremely preterm babies and interaction with maternal factors.
MedLine Citation:
PMID:  15935933     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Preterm delivery is associated with an increased risk of cerebral palsy (CP). The greatest risk is for infants born <28 weeks' gestation. AIMS: To identify significant neonatal risk factors for CP and explore the interactions between antenatal and neonatal risk factors, among extremely preterm infants of 27 weeks' gestation or less. STUDY DESIGN: Nested case control design. METHODS: Infants born between 1989 and 1996, at 24-27 weeks' gestation, were evaluated: 30 with CP at 2 years corrected age and 120 control infants matched for gestation age. Neonatal variables were compared using matched analyses with the interaction between antenatal and neonatal factors being examined using logistic regression analyses. RESULTS: Risk factors for CP on matched analyses included patent ductus arteriosus requiring surgical ligation, peri-intraventricular haemorrhage, moderate to severe ventricular dilatation, periventricular leukomalacia (PVL) and need for home oxygen. Independent neonatal predictors were ventricular dilatation (OR 7.3; 95% CI 1.6, 32.3), PVL (OR 29.8; 95% CI 5.6, 159.1) and home oxygen use (OR 3.4; 95% CI 1.2, 9.4). No interaction terms in the logistic models were significant between the previously identified pregnancy risk factors of absence of antenatal steroids and intrauterine growth restriction and the neonatal risk factors. CONCLUSIONS: PVL is the most powerful independent predictor of CP in extremely preterm infants of 27 weeks' gestation or less and appears to be uninfluenced by antenatal factors.
Uyen Tran; Peter H Gray; Michael J O'Callaghan
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Publication Detail:
Type:  Journal Article     Date:  2005-02-24
Journal Detail:
Title:  Early human development     Volume:  81     ISSN:  0378-3782     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-06     Completed Date:  2006-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  555-61     Citation Subset:  IM    
Developmental Paediatrics and Rehabilitation, University of Queensland, Mater Children's Hospital, South Brisbane, Queensland, Australia.
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MeSH Terms
Cerebral Palsy / diagnosis*,  etiology*
Infant, Newborn
Infant, Premature
Leukomalacia, Periventricular / complications*
Logistic Models
Premature Birth / complications*
Risk Factors

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