Document Detail


Perinatal events and the risk of intraparenchymal echodensity in very-low-birthweight neonates.
MedLine Citation:
PMID:  9805714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A case-control study was performed to identify perinatal events associated with intraparenchymal echodensity on cranial ultrasonography--an important antecedent of cerebral palsy in very-low-birthweight infants. Forty-eight infants with birthweight < 1500 g and intraparenchymal echodensity on cranial ultrasound examination and 90 controls with normal cranial ultrasounds were identified within a cohort of 1791 consecutive very-low-birthweight infants born at a regional obstetric referral centre. Data about potential risk factors were obtained from medical records of cases and controls. Among prenatal factors, chorioamnionitis (odds ratio[OR]: 3.2; 95% confidence interval: 1.3, 8.1) and placental abruption (OR 2.6 [1.0, 6.6]) were associated most strongly with an increased risk of intraparenchymal echodensity and pre-eclampsia (OR 0.3 [0.1, 0.8]) was associated most strongly with a decreased risk. When controlling for gestational age, multiple gestation was also associated with an increased risk (OR 2.7 [1.0, 7.5]). Neonatal factors independently associated with an increased risk included low systolic blood pressure (< 33 mmHg in the first 12 h of life; odds ratio 8.0 [2.0, 31.3]), receipt of a fluid bolus in the first 12 h of life (OR 19.7 [4.6, 84.3]), need for cardiopulmonary resuscitation in the first 72 h (OR 6.9 [1.5, 31.3]) and pneumothorax in the first 72 h of life (OR 27.0 [4.3, 167.2]). When analyses were restricted to infants who were not given a fluid bolus, the associations with chorioamnionitis and placental abruption were attenuated. When excluding infants who had a pneumothorax, the associations with placental abruption and multiple gestation were attenuated. Restriction of infants with systolic blood pressure < 33 mmHg resulted in attenuation of associations with pre-eclampsia and multiple gestation. These analyses suggest the possibility that potentially modifiable postnatal events may be involved as intervening factors linking chorioamnionitis, placental abruption and multiple gestation with subsequent intraparenchymal echodensity.
Authors:
T M O'Shea; J M Kothadia; D D Roberts; R G Dillard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Paediatric and perinatal epidemiology     Volume:  12     ISSN:  0269-5022     ISO Abbreviation:  Paediatr Perinat Epidemiol     Publication Date:  1998 Oct 
Date Detail:
Created Date:  1999-01-20     Completed Date:  1999-01-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8709766     Medline TA:  Paediatr Perinat Epidemiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  408-21     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
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MeSH Terms
Descriptor/Qualifier:
Abruptio Placentae / complications
Case-Control Studies
Cerebral Hemorrhage / complications
Cerebral Palsy / etiology*,  pathology,  ultrasonography*
Chorioamnionitis / complications
Confounding Factors (Epidemiology)
Female
Humans
Infant, Newborn
Infant, Premature, Diseases / etiology*,  pathology,  ultrasonography*
Infant, Very Low Birth Weight*
Logistic Models
Multivariate Analysis
Odds Ratio
Parity
Pre-Eclampsia / complications
Pregnancy
Risk Factors

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


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