Influence of obstetric management on outcome of extremely preterm growth retarded infants
a Department of Obstetrics, b Department of Neonatology, Academic
Medical Centre, University of Amsterdam, c Department of Obstetrics, University Hospital,
Utrecht, d Department of Neonatology,
Wilhelmina Children's Hospital, Utrecht, e TNO Institute of Preventive Health Care, Leiden
Correspondence to: Dr AHP Schaap, PO Box 22700, 1100 DE Amsterdam, The Netherlands.
Accepted 15 April 1997
AIM
To describe the long term outcome of
extremely preterm growth retarded infants in relation to
obstetric management and various perinatal events.
METHODSA cohort study was undertaken in two
tertiary care centres with different obstetric management. All infants
with fetal growth retardation due to placental insufficiency
and resulting in fetal distress at 26 to 32 weeks of gestation, were
included for the years 1984-89. Main outcome measures were
impairment, disability, or handicap at 2 years corrected age and at
school age (4 1/2 to 10 1/2 years).
RESULTSOne hundred and twenty five (98%) were
followed up until 2 years corrected age in the outpatient
department; 114 (90%) were assessed at school age. Impairments
were found in 37% and disabilities or handicaps in 9% of the
assessed infants, with no difference between centres. All
disabled or handicapped children had already been
identified by 2 years corrected age.
CONCLUSIONSDisability or handicap were
related to neonatal complications (intracerebral haemorrhage or
bronchopulmonary dysplasia) and not to obstetric variables, thus making
antenatal prediction impossible. The incidence of disability or
handicap in these growth retarded infants was comparable with that
of other preterm infants.
© 1997 by Archives of Disease in Childhood
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