Neonatal antecedents for cerebral palsy in extremely preterm babies and interaction with maternal factors

Tran, Uyen, Gray, Peter H. and O'Callaghan, Michael J. (2005) Neonatal antecedents for cerebral palsy in extremely preterm babies and interaction with maternal factors. Early Human Development, 81 6: 555-561. doi:10.1016/j.earlhumdev.2004.12.009


Author Tran, Uyen
Gray, Peter H.
O'Callaghan, Michael J.
Title Neonatal antecedents for cerebral palsy in extremely preterm babies and interaction with maternal factors
Journal name Early Human Development   Check publisher's open access policy
ISSN 1872-6232
0378-3782
Publication date 2005-06
Sub-type Article (original research)
DOI 10.1016/j.earlhumdev.2004.12.009
Volume 81
Issue 6
Start page 555
End page 561
Total pages 7
Editor E. F. Maalouf
Place of publication Shannon, Co. Clare Ireland
Publisher Elsevier
Collection year 2005
Language eng
Subject 321019 Paediatrics
730204 Child health
Formatted abstract
Background:
Preterm delivery is associated with an increased risk of cerebral palsy (CP). The greatest risk is for infants born < 28 weeks' gestation.

Aims:
To identify significant neonatal risk factors for CP and explore the interactions between antenatal and neonatal risk factors, among extremely preterm infants of 27 weeks' gestation or less. Study Design: Nested case control design.

Methods:

Infants born between 1989 and 1996, at 24-27 weeks' gestation, were evaluated: 30 with CP at 2 years corrected age and 120 control infants matched for gestation age. Neonatal variables were compared using matched analyses with the interaction between antenatal and neonatal factors being examined using logistic regression analyses.

Results:
Risk factors for CP on matched analyses included patent ductus arteriosus requiring surgical ligation, peri-intraventricular haemorrhage, moderate to severe ventricular dilatation, periventricular leukomalacia (PVL) and need for home oxygen. Independent neonatal predictors were ventricular dilatation (OR 7.3; 95% Cl 1.6, 32.3), PVL (OR 29.8; 95% Cl 5.6, 159.1) and home oxygen use (OR 3.4; 95% Cl 1.2, 9.4). No interaction terms in the logistic models were significant between the previously identified pregnancy risk factors of absence of antenatal. steroids and intrauterine growth restriction and the neonatal risk factors.

Conclusions:

PVL is the most powerful independent predictor of CP in extremely preterm infants of 27 weeks' gestation or less and appears to be uninfluenced by antenatal factors. (c) 2004 Published by Elsevier Ireland Ltd.
Keyword Obstetrics & Gynecology
Pediatrics
Periventricular Leukomalacia
Cerebral Palsy
Preterm Delivery
Infants
Birth-weight Infants
Severe Bronchopulmonary Dysplasia
White-matter Damage
Risk-factors
Children
Ultrasonography
Impairment
Infection
Newborn
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 06:03:35 EST