Document Detail


Neurodevelopmental outcomes of extremely low-gestational-age neonates with low-grade periventricular-intraventricular hemorrhage.
MedLine Citation:
PMID:  23460139     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
IMPORTANCE: Low-grade periventricular-intraventricular hemorrhage is a common neurologic morbidity among extremely low-gestational-age neonates, yet the outcomes associated with this morbidity are not fully understood. In a contemporary multicenter cohort, we evaluated the impact of such hemorrhages on early (18-22 month) neurodevelopmental outcomes of extremely premature infants.
OBJECTIVE: To compare neurodevelopmental outcomes at 18 to 22 months' corrected age for extremely low-gestational-age infants with low-grade (grade 1 or 2) periventricular-intraventricular hemorrhage with those of infants with either no hemorrhage or severe (grade 3 or 4) hemorrhage demonstrated on cranial ultrasonography.
DESIGN: Longitudinal observational study.
SETTING: Sixteen centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.
PARTICIPANTS: A total of 1472 infants born at less than 27 weeks' gestational age between January 1, 2006, and December 31, 2008, with ultrasonography results within the first 28 days of life and surviving to 18 to 22 months with complete follow-up assessments were eligible.
MAIN EXPOSURE: Low-grade periventricular-intraventricular hemorrhage.
MAIN OUTCOME MEASURES: Outcomes included cerebral palsy; gross motor functional limitation; cognitive and language scores according to the Bayley Scales of Infant Development, 3rd Edition; and composite measures of neurodevelopmental impairment. Regression modeling evaluated the association of hemorrhage severity with adverse outcomes while controlling for potentially confounding variables and center differences.
RESULTS: Low-grade hemorrhage was not associated with significant differences in unadjusted or adjusted risk of any adverse neurodevelopmental outcome compared with infants without hemorrhage. Compared with low-grade hemorrhage, severe hemorrhage was associated with decreased adjusted continuous cognitive (β, -3.91 [95% CI, -6.41 to -1.42]) and language (β, -3.19 [-6.19 to -0.19]) scores as well as increased odds of each adjusted categorical outcome except severe cognitive impairment (odds ratio [OR], 1.46 [0.74 to 2.88]) and mild language impairment (OR, 1.35 [0.88 to 2.06]).
CONCLUSIONS AND RELEVANCE: At 18 to 22 months, the neurodevelopmental outcomes of extremely low-gestational-age infants with low-grade periventricular-intraventricular hemorrhage are not significantly different from those without hemorrhage. Additional study at school age and beyond would be informative.
Authors:
Allison H Payne; Susan R Hintz; Anna Maria Hibbs; Michele C Walsh; Betty R Vohr; Carla M Bann; Deanne E Wilson-Costello;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA pediatrics     Volume:  167     ISSN:  2168-6211     ISO Abbreviation:  JAMA Pediatr     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-06     Completed Date:  2013-07-02     Revised Date:  2014-08-20    
Medline Journal Info:
Nlm Unique ID:  101589544     Medline TA:  JAMA Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  451-9     Citation Subset:  AIM; IM    
Export Citation:
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerebral Palsy / epidemiology,  etiology
Child, Preschool
Cognition Disorders / epidemiology,  etiology
Developmental Disabilities / epidemiology*,  etiology
Echoencephalography
Female
Humans
Infant
Infant, Extremely Premature*
Infant, Newborn
Intracranial Hemorrhages / epidemiology*,  ultrasonography
Language Development Disorders / epidemiology,  etiology
Longitudinal Studies
Male
Motor Skills Disorders / epidemiology,  etiology
Multivariate Analysis
Risk
Risk Factors
United States / epidemiology
Grant Support
ID/Acronym/Agency:
5T32HD060537-01/HD/NICHD NIH HHS; L40 HD067021/HD/NICHD NIH HHS; M01 RR000070/RR/NCRR NIH HHS; M01 RR000080/RR/NCRR NIH HHS; T32 HD060537/HD/NICHD NIH HHS; U10 HD021364/HD/NICHD NIH HHS; U10 HD021373/HD/NICHD NIH HHS; U10 HD021385/HD/NICHD NIH HHS; U10 HD021397/HD/NICHD NIH HHS; U10 HD027851/HD/NICHD NIH HHS; U10 HD027853/HD/NICHD NIH HHS; U10 HD027856/HD/NICHD NIH HHS; U10 HD027871/HD/NICHD NIH HHS; U10 HD027880/HD/NICHD NIH HHS; U10 HD027904/HD/NICHD NIH HHS; U10 HD034216/HD/NICHD NIH HHS; U10 HD036790/HD/NICHD NIH HHS; U10 HD040461/HD/NICHD NIH HHS; U10 HD040492/HD/NICHD NIH HHS; U10 HD040498/HD/NICHD NIH HHS; U10 HD040521/HD/NICHD NIH HHS; U10 HD040689/HD/NICHD NIH HHS; U10 HD053089/HD/NICHD NIH HHS; U10 HD053109/HD/NICHD NIH HHS; U10 HD053119/HD/NICHD NIH HHS; U10 HD053124/HD/NICHD NIH HHS; UL1 TR000041/TR/NCATS NIH HHS; UL1 TR000142/TR/NCATS NIH HHS; UL1 TR000439/TR/NCATS NIH HHS
Investigator
Investigator/Affiliation:
Michael S Caplan / ; Abbot R Laptook / ; Angelita M Hensman / ; Robert Burke / ; Melinda Caskey / ; Katharine Johnson / ; Barbara Alksninis / ; Dawn Andrews / ; Kristen Angela / ; Theresa M Leach / ; Victoria E Watson / ; Suzy Ventura / ; Avroy A Fanaroff / ; Nancy S Newman / ; Bonnie S Siner / ; Monika Bhola / ; Gulgun Yalcinkaya / ; Harriet G Friedman / ; Kurt Schibler / ; Edward F Donovan / ; Kate Bridges / ; Barbara Alexander / ; Cathy Grisby / ; Holly L Mincey / ; Jody Hessling / ; Teresa L Gratton / ; Jean J Steichen / ; Kimberly Yolton / ; Ronald N Goldberg / ; C Michael Cotten / ; Kathy J Auten / ; Kimberley A Fisher / ; Sandra Grimes / ; Kathryn E Gustafson / ; Melody B Lohmeyer / ; Barbara J Stoll / ; David P Carlton / ; Ellen C Hale / ; Rosemary D Higgins / ; Stephanie Wilson Archer / ; Brenda B Poindexter / ; Anna M Dusick / ; Leslie Dawn Wilson / ; Faithe Hamer / ; Carolyn Lytle / ; Heike M Minnich / ; Abhik Das / ; W Kenneth Poole / ; Dennis Wallace / ; Jamie E Newman / ; Jeanette O' Donnell Auman / ; Margaret Cunningham / ; Carolyn M Petrie Huitema / ; Kristin M Zaterka-Baxter / ; Krisa P Van Meurs / ; David K Stevenson / ; Alexis S Davis / ; M S Epi / ; M Bethany Ball / ; Andrew W Palmquist / ; Melinda S Proud / ; Elizabeth Bruno / ; Maria Elena DeAnda / ; Anne M DeBattista / ; Jean G Kohn / ; Hali E Weiss / ; Ivan D Frantz / ; John M Fiascone / ; Brenda L MacKinnon / ; Anne Furey / ; Ellen Nylen / ; Elisabeth C McGowan / ; Waldemar A Carlo / ; Namasivayam Ambalavanan / ; Myriam Peralta-Carcelen / ; Monica V Collins / ; Shirley S Cosby / ; Fred J Biasini / ; Kristen C Johnston / ; Kathleen G Nelson / ; Cryshelle S Patterson / ; Vivien A Phillips / ; Sally Whitley / ; Neil N Finer / ; Yvonne E Vaucher / ; David Kaegi / ; Maynard R Rasmussen / ; David Kaegi / ; Kathy Arnell / ; Clarence Demetrio / ; Martha G Fuller / ; Wade Rich / ; Radmila West / ; Edward F Bell / ; Michael J Acarregui / ; Karen J Johnson / ; Diane L Eastman / ; Shahnaz Duara / ; Charles R Bauer / ; Ruth Everett-Thomas / ; Sylvia Hiriart-Fajardo / ; Arielle Rigaud / ; Maria Calejo / ; Silvia M Frade Eguaras / ; Michelle Harwood Berkowits / ; Andrea Garcia / ; Helina Pierre / ; Alexandra Stoerger / ; Kristi L Watterberg / ; Jean R Lowe / ; Janell F Fuller / ; Robin K Ohls / ; Conra Backstrom Lacy / ; Rebecca Montman / ; Dale L Phelps / ; Gary J Myers / ; Linda J Reubens / ; Erica Burnell / ; Diane Hust / ; Julie Babish Johnson / ; Rosemary L Jensen / ; Emily Kushner / ; Joan Merzbach / ; Kelley Yost / ; Lauren Zwetsch / ; Kathleen A Kennedy / ; Jon E Tyson / ; Nora I Alaniz / ; Patricia W Evans / ; Charles Green / ; Beverly Foley Harris / ; Margarita Jiminez / ; Anna E Lis / ; Sarah Martin / ; E McDavid / ; Brenda H Morris / ; M Layne Poundstone / ; Saba Siddiki / ; Maegan C Simmons / ; Patti L Pierce Tate / ; Sharon L Wright / ; Pablo J Sánchez / ; Roy J Heyne / ; Walid A Salhab / ; Charles R Rosenfeld / ; Alicia Guzman / ; Melissa H Leps / ; Nancy A Miller / ; Gaynelle Hensley / ; Sally S Adams / ; Linda A Madden / ; Elizabeth Heyne / ; Janet S Morgan / ; Catherine Twell Boatman / ; Lizette E Torres / ; Roger G Faix / ; Bradley A Yoder / ; Karen A Osborne / ; Cynthia Spencer / ; Kimberlee Weaver-Lewis / ; Shawna Baker / ; Karie Bird / ; Jill Burnett / ; Mike Steffen / ; Karen Zanetti / ; T Michael O' Shea / ; Robert G Dillard / ; Lisa K Washburn / ; Barbara G Jackson / ; Nancy Peters / ; Korinne Chiu / ; Deborah Evans Allred / ; Donald J Goldstein / ; Raquel Halfond / ; Carroll Peterson / ; Ellen L Waldrep / ; Cherrie D Welch / ; Melissa Whalen Morris / ; Gail Wiley Hounshell / ; Seetha Shankaran / ; Athina Pappas / ; Rebecca Bara / ; Laura A Goldston / ; Richard A Ehrenkranz / ; Harris Jacobs / ; Christine G Butler / ; Patricia Cervone / ; Sheila Greisman / ; Monica Konstantino / ; JoAnn Poulsen / ; Janet Taft / ; Joanne Williams / ; Elaine Romano /
Comments/Corrections
Comment In:
JAMA Pediatr. 2013 May;167(5):487-8   [PMID:  23460028 ]

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