Document Detail


Survival and long-term neurodevelopmental outcome of extremely premature infants born at 23-26 weeks' gestational age at a tertiary center.
MedLine Citation:
PMID:  14702487     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Long-term outcome, including school-age function, has been infrequently reported in infants born at ages as young as 23-26 weeks' gestation. The objective of this study is to report outcome on a large cohort of these infants to understand better the risks and factors that affect survival and long-term prognosis. METHODS: Records from 1036 infants who were born between January 1, 1986, and December 31, 2000, were analyzed retrospectively by logistic regression to correlate multiple factors with both survival and long-term outcome. A total of 675 surviving infants were analyzed at a mean age of 47.5 months for developmental outcome. A subset of 147 surviving infants who were born before 1991 were followed through school-age years using the University of Vermont Achenbach Child Behavioral Checklist and Teachers Report Form. Longitudinal follow-up was performed comparing 1-year outcome with school-age performance. RESULTS: Gestational age and recent year of birth correlated highly with survival. Maternal nonwhite race, female sex, inborn status, surfactant therapy, single gestation, and secondary sepsis also correlated positively with survival. Normal cranial ultrasound results, absence of chronic lung disease, female sex, cesarean delivery, and increased birth weight correlated favorably with long-term outcome. Infants who were born at 23 weeks were more likely to have severe impairments compared with those who were born at 24-26 weeks. Early follow-up identified most subsequent physical impairments but correlated poorly with school-age function. CONCLUSIONS: Survival continues to improve for infants who are born at extremely early gestational ages, but long-term developmental concerns continue to be prevalent. Early outcomes do not reliably predict school-age performance. Strategies that reduce severe intraventricular hemorrhage and chronic lung disease will likely yield the best chances to improve long-term outlook.
Authors:
Ronald E Hoekstra; T Bruce Ferrara; Robert J Couser; Nathaniel R Payne; John E Connett
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  113     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-02     Completed Date:  2004-01-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Neonatology, Children's Hospitals and Clinics of Minneapolis, Minneapolis, Minnesota 55404, USA. rhoek99406@aol.com
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MeSH Terms
Descriptor/Qualifier:
Child
Child Development*
Child, Preschool
Developmental Disabilities / epidemiology*
Female
Follow-Up Studies
Gestational Age
Humans
Infant, Newborn
Infant, Premature*
Infant, Very Low Birth Weight
Logistic Models
Male
Retrospective Studies
Sex Factors
Survival Rate

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


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