Register for email alerts and news feeds:
This journal | BMJ Group
rss
Archives of Disease in Childhood - Fetal and Neonatal Edition 1999;80:F115-F117; doi:10.1136/fn.80.2.F115
Copyright © 1999 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Arch Dis Child Fetal Neonatal Ed 1999;80:F115-F117 ( March )

Trends in incidence of cranial ultrasound lesions and cerebral palsy in very low birthweight infants 1982-93

Richard W I Cooke

Department of Child Health, University of Liverpool Regional Neonatal Intensive Care Unit, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS

Correspondence to: Dr R W I Cooke.


Accepted 16 October 1998

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.

Keywords: very low birthweight; cerebral haemorrhage; cranial ultrasound; cerebral palsy; antenatal corticosteroid


© 1999 by Archives of Disease in Childhood

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

This article has been cited by other articles:

  • Kuban, K. C. K., Allred, E. N., O'Shea, T. M., Paneth, N., Pagano, M., Dammann, O., Leviton, A., Du Plessis, A., Westra, S. J., Miller, C. R., Bassan, H., Krishnamoorthy, K., Junewick, J., Olomu, N., Romano, E., Seibert, J., Engelke, S., Karna, P., Batton, D., O'Connor, S. E., Keller, C. E. (2009). Cranial Ultrasound Lesions in the NICU Predict Cerebral Palsy at Age 2 Years in Children Born at Extremely Low Gestational Age. J Child Neurol 24: 63-72 [Abstract]  
  • Marlow, N (2004). Neurocognitive outcome after very preterm birth. Arch. Dis. Child. Fetal Neonatal Ed. 89: F224-F228 [Abstract] [Full Text]  
  • Jeng, S.-F., Chen, L.-C., Tsou, K.-I., Chen, W. J, Luo, H.-J. (2004). Relationship Between Spontaneous Kicking and Age of Walking Attainment in Preterm Infants With Very Low Birth Weight and Full-Term Infants. ptjournal 84: 159-172 [Abstract] [Full Text]  
  • Counsell, S. J., Allsop, J. M., Harrison, M. C., Larkman, D. J., Kennea, N. L., Kapellou, O., Cowan, F. M., Hajnal, J. V., Edwards, A. D., Rutherford, M. A. (2003). Diffusion-Weighted Imaging of the Brain in Preterm Infants With Focal and Diffuse White Matter Abnormality. Pediatrics 112: 1-7 [Abstract] [Full Text]  
  • Cooke, R W I, Foulder-Hughes, L (2003). Growth impairment in the very preterm and cognitive and motor performance at 7 years. Arch. Dis. Child. 88: 482-487 [Abstract] [Full Text]  
  • Gaillard, E A, Cooke, R W I, Shaw, N J (2001). Improved survival and neurodevelopmental outcome after prolonged ventilation in preterm neonates who have received antenatal steroids and surfactant. Arch. Dis. Child. Fetal Neonatal Ed. 84: 194F-196 [Abstract] [Full Text]  
  • Wright, N. P., Wales;, J. K. H., O'Shea, T. M. (2000). Brain Damage and Dexamethasone?. Pediatrics 106: 864-864 [Abstract] [Full Text]  
  • Boyle, C. A., Yeargin-Allsopp, M., Schendel, D. E., Holmgreen, P., Oakley, G. P. (2000). Tocolytic Magnesium Sulfate Exposure and Risk of Cerebral Palsy among Children with Birth Weights Less Than 1,750 Grams. Am J Epidemiol 152: 120-124 [Abstract] [Full Text]  
  • Watts, P., Adams, G G W, Thomas, R M, Bunce, C. (2000). Intraventricular haemorrhage and stage 3 retinopathy of prematurity. Br. J. Ophthalmol. 84: 596-599 [Abstract] [Full Text]  

This Article

Services
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

Latest from ADC

 

ADC is co-owned by the RCPCH and is the official journal of the European Academy of Paediatrics

BMJ Careers - Latest Paediatrics and Paediatric Surgery Jobs

Paediatrics and Paediatric Surgery Jobs