Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months

Schmidt, B., Asztalos, E. V., Roberts, R. S., Robertson, C. M. T., Sauve, R. S., Whitfield, M. F., Pritchard, M. A. and Colditz, P. B. (2003) Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months. J A M A: The Journal of the American Medical Association, 289 9: 1124-1129. doi:10.1001/jama.289.9.1124


Author Schmidt, B.
Asztalos, E. V.
Roberts, R. S.
Robertson, C. M. T.
Sauve, R. S.
Whitfield, M. F.
Pritchard, M. A.
Colditz, P. B.
Title Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months
Journal name J A M A: The Journal of the American Medical Association   Check publisher's open access policy
ISSN 0098-7484
Publication date 2003
Sub-type Article (original research)
DOI 10.1001/jama.289.9.1124
Open Access Status DOI
Volume 289
Issue 9
Start page 1124
End page 1129
Total pages 6
Editor R. Glass
P. Fontanarosa
Place of publication Chicago
Publisher American Medical Association
Collection year 2003
Language eng
Subject C1
321014 Obstetrics and Gynaecology
730204 Child health
Abstract CONTEXT: Despite more than 2 decades of outcomes research after very preterm birth, clinicians remain uncertain about the extent to which neonatal morbidities predict poor long-term outcomes of extremely low-birth-weight (ELBW) infants. OBJECTIVE: To determine the individual and combined prognostic effects of bronchopulmonary dysplasia (BPD), ultrasonographic signs of brain injury, and severe retinopathy of prematurity (ROP) on 18-month outcomes of ELBW infants. DESIGN: Inception cohort assembled for the Trial of Indomethacin Prophylaxis in Preterms (TIPP). SETTING AND PARTICIPANTS: A total of 910 infants with birth weights of 500 to 999 g who were admitted to 1 of 32 neonatal intensive care units in Canada, the United States, Australia, New Zealand, and Hong Kong between 1996 and 1998 and who survived to a postmenstrual age of 36 weeks. MAIN OUTCOME MEASURES: Combined end point of death or survival to 18 months with 1 or more of cerebral palsy, cognitive delay, severe hearing loss, and bilateral blindness. RESULTS: Each of the neonatal morbidities was similarly and independently correlated with a poor 18-month outcome. Odds ratios were 2.4 (95% confidence interval [CI], 1.8-3.2) for BPD, 3.7 (95% CI, 2.6-5.3) for brain injury, and 3.1 (95% CI, 1.9-5.0) for severe ROP. In children who were free of BPD, brain injury, and severe ROP the rate of poor long-term outcomes was 18% (95% CI, 14%-22%). Corresponding rates with any 1, any 2, and all 3 neonatal morbidities were 42% (95% CI, 37%-47%), 62% (95% CI, 53%-70%), and 88% (64%-99%), respectively. CONCLUSION: In ELBW infants who survive to a postmenstrual age of 36 weeks, a simple count of 3 common neonatal morbidities strongly predicts the risk of later death or neurosensory impairment.
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2004 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 01:42:09 EST