| Trends in incidence of cranial ultrasound lesions and cerebral palsy in very low birthweight infants 1982-93. | |
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MedLine Citation:
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PMID: 10325787 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To evaluate the effects of changing perinatal practice on outcome in terms of cranial ultrasound appearances and subsequent cerebral palsy rates in survivors. METHODS: A tertiary neonatal centre based prospective cohort study was undertaken of very low birthweight infants, in three 4 year periods: 1982-5, 1986-9, 1990-3. Rates of survival, parenchymal cerebral haemorrhage (PH), and leucomalacia on cerebral ultrasound scans, and cerebral palsy (CP) at the age of 3 years were compared. Antenatal steroid prophylaxis and postnatal surfactant use were also compared. RESULTS: VLBW infants (1722) were admitted over the 12 years, of whom 1268 (73.6%) were discharged home. Neonatal survival increased significantly over the three periods (69.2%, 72.9%, 79.7%; p < 0.0001). PH declined from 14.9% to 10.5% (p = 0.032) after 1990 as did CP rate (10.9% to 7.3%; p = 0.046). The use of antenatal steroids and postnatal surfactant greatly increased during this period. Steroid use was significantly associated with increased survival (OR 3.34, 2.31-4.79), decreased PH (OR 0.44, 0.28-0.71), and decreased risk of CP in survivors (OR 0.47, 0.27-0.81) after standardising for gestation, birthweight, sex, place and mode of delivery. Similar effects for surfactant did not remain significant after steroid use had been accounted for. CONCLUSION: Improved survival in VLBW infants since 1990 has been accompanied by a fall in PH and subsequent CP rates in survivors. This change is most likely to be due to the greater use of antenatal steroid prophylaxis. |
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Authors:
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R W Cooke |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of disease in childhood. Fetal and neonatal edition Volume: 80 ISSN: 1359-2998 ISO Abbreviation: Arch. Dis. Child. Fetal Neonatal Ed. Publication Date: 1999 Mar |
Date Detail:
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Created Date: 1999-05-20 Completed Date: 1999-05-20 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9501297 Medline TA: Arch Dis Child Fetal Neonatal Ed Country: ENGLAND |
Other Details:
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Languages: eng Pagination: F115-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Child Health, University of Liverpool Regional Neonatal Intensive Care Unit, Liverpool Women's Hospital. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cerebral Hemorrhage
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diagnosis* Cerebral Palsy / epidemiology* Chi-Square Distribution Databases, Factual Echoencephalography England / epidemiology Glucocorticoids / therapeutic use Humans Incidence Infant, Newborn Infant, Very Low Birth Weight* Intensive Care, Neonatal / methods* Leukomalacia, Periventricular / diagnosis* Prevalence Prospective Studies Pulmonary Surfactants / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Glucocorticoids; 0/Pulmonary Surfactants |
| Comments/Corrections | |
Comment In:
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Arch Dis Child Fetal Neonatal Ed. 2000 May;82(3):F259
[PMID:
10885939
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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