|
|
||||||||||||||
|
|
|||||||||||||||
ORIGINAL ARTICLE |
1 Academic Division of Child Health, University of Nottingham, Nottingham, UK
2 Queen Mary, University of London, London, UK
3 Jessop Wing, Royal Hallamshire Hospital, Sheffield, UK
4 Department of Paediatrics, University of Oxford, Oxford, UK
Correspondence to:
Correspondence to:
Dr Marlow
Academic Division of Child Health, Level E East Block, Queens Medical Centre, Nottingham NG7 2UH, UK; neil.marlow{at}nottingham.ac.uk
Aims: To describe perinatal factors associated with later morbidity among extremely preterm children at 30 months of age corrected for prematurity.
Population: Of 308 surviving children born at
25 weeks gestation in the United Kingdom and Ireland from March to December 1995, 283 (92%) were evaluated at 30 months of age corrected for prematurity.
Methods: Cerebral palsy, severe motor disability, and Bayley scores were used as dependent variables in sequential multiple regression analyses to identify factors associated with adverse outcomes.
Results: Adverse outcomes were consistently more common in boys. Factors related to perinatal illness, ultrasound evidence of brain injury, and treatment (particularly postnatal steroids) were associated with adverse motor outcomes (cerebral palsy, disability or Bayley psychomotor development index). Increasing duration of postnatal steroid treatment was associated with poor motor outcomes. A score was developed for severe motor disability with good negative predictive value. In contrast, mental development was associated with a broader range of factors: ethnic group, maternal educational level, the use of antenatal steroids, and prolonged rupture of membranes in addition to chronic lung disease.
Conclusion: Male sex is a pervasive risk factor for poor outcome at extremely low gestations. Avoidable or effective treatment factors are identified, which may indicate the potential for improving outcome.
Abbreviations: MDI, mental development index; PDI, psychomotor development index
Keywords: preterm; developmental disability; neurological disability
This article has been cited by other articles:
![]() |
G. K. Swamy, T. Ostbye, and R. Skjaerven Association of Preterm Birth With Long-term Survival, Reproduction, and Next-Generation Preterm Birth JAMA, March 26, 2008; 299(12): 1429 - 1436. [Abstract] [Full Text] [PDF] |
||||
![]() |
M A Bracewell, E M Hennessy, D Wolke, and N Marlow The EPICure study: growth and blood pressure at 6 years of age following extremely preterm birth Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2008; 93(2): F108 - F114. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Arnaud, L. Daubisse-Marliac, M. White-Koning, V. Pierrat, B. Larroque, H. Grandjean, C. Alberge, S. Marret, A. Burguet, P.-Y. Ancel, et al. Prevalence and Associated Factors of Minor Neuromotor Dysfunctions at Age 5 Years in Prematurely Born Children: The EPIPAGE Study Arch Pediatr Adolesc Med, November 1, 2007; 161(11): 1053 - 1061. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. J. Barrington and N. N. Finer Inhaled Nitric Oxide for Preterm Infants: A Systematic Review Pediatrics, November 1, 2007; 120(5): 1088 - 1099. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Limperopoulos, H. Bassan, K. Gauvreau, R. L. Robertson Jr, N. R. Sullivan, C. B. Benson, L. Avery, J. Stewart, J. S. S. MD, S. A. Ringer, et al. Does Cerebellar Injury in Premature Infants Contribute to the High Prevalence of Long-term Cognitive, Learning, and Behavioral Disability in Survivors? Pediatrics, September 1, 2007; 120(3): 584 - 593. [Abstract] [Full Text] [PDF] |
||||
![]() |
J Cornish, E Tan, J Teare, T G Teoh, R Rai, S K Clark, and P P Tekkis A meta-analysis on the influence of inflammatory bowel disease on pregnancy Gut, June 1, 2007; 56(6): 830 - 837. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. F Williams, C. C Kingdon, and G. Weaver Banking for the future: investing in human milk Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2007; 92(3): F158 - F159. [Full Text] [PDF] |
||||
![]() |
C. M Rees, A. Pierro, and S. Eaton Neurodevelopmental outcomes of neonates with medically and surgically treated necrotizing enterocolitis Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2007; 92(3): F193 - F198. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Z. Khan, H. Muslima, M. Parveen, M. Bhattacharya, N. Begum, S. Chowdhury, M. Jahan, and G. L. Darmstadt Neurodevelopmental Outcomes of Preterm Infants in Bangladesh Pediatrics, July 1, 2006; 118(1): 280 - 289. [Abstract] [Full Text] [PDF] |
||||
![]() |
A H Shennan and S Bewley Why should preterm births be rising? BMJ, April 22, 2006; 332(7547): 924 - 925. [Full Text] [PDF] |
||||
![]() |
A. Fily, V. Pierrat, V. Delporte, G. Breart, P. Truffert, and on behalf of the EPIPAGE Nord-Pas-de-Calais Study Factors Associated With Neurodevelopmental Outcome at 2 Years After Very Preterm Birth: The Population-Based Nord-Pas-de-Calais EPIPAGE Cohort Pediatrics, February 1, 2006; 117(2): 357 - 366. [Abstract] [Full Text] [PDF] |
||||
Read all eLetters
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
| ARCH DIS CHILD | FETAL NEONATAL ED | ED PRACTICE |