BACKGROUND: Uncertainty continues regarding the extent to which neonatal morbidities predict poor long-term outcome and functional abilities in extremely preterm infants. OBJECTIVE: The goal of this study was to determine the impact of bronchopulmonary dysplasia (BPD), ultrasonographic signs of brain injury, and severe retinopathy of prematurity (ROP) on 11-year outcomes in infants born at <26 weeks' gestation. METHODS: A total of 247 infants were born alive before 26 completed weeks of gestation from 1990 through 1992 in all of Sweden, and 98 (40%) survived to a postmenstrual age of 36 weeks. Main outcome measures were (1) poor outcome, defined as combined end point of death after 36 weeks' postmenstrual age or survival with at least 1 major disability at 11 years, and (2) consequences of chronic conditions in the survivors according to a validated instrument administered to parents. RESULTS: Brain injury and severe ROP but not BPD correlated independently with poor outcome at 11 years of age. Among children who were free from BPD, brain injury, and severe ROP, 10% had a poor outcome. Corresponding rates with any 1, any 2, and all 3 neonatal morbidities were 19%, 58%, and 80%, respectively. Multivariate analysis revealed that brain injury and severe ROP were associated with high rates of consequences of chronic conditions. CONCLUSIONS: In infants born extremely preterm who survive to a postmenstrual age of 36 weeks, severe ROP and brain injury separately predict the risk of death or major disability at 11 years of age. Thus, continued research to determine how to prevent these complications of prematurity is critical.
BACKGROUND: Uncertainty continues regarding the extent to which neonatal morbidities predict poor long-term outcome and functional abilities in extremely preterm infants. OBJECTIVE: The goal of this study was to determine the impact of bronchopulmonary dysplasia (BPD), ultrasonographic signs of brain injury, and severe retinopathy of prematurity (ROP) on 11-year outcomes in infants born at <26 weeks' gestation. METHODS: A total of 247 infants were born alive before 26 completed weeks of gestation from 1990 through 1992 in all of Sweden, and 98 (40%) survived to a postmenstrual age of 36 weeks. Main outcome measures were (1) poor outcome, defined as combined end point of death after 36 weeks' postmenstrual age or survival with at least 1 major disability at 11 years, and (2) consequences of chronic conditions in the survivors according to a validated instrument administered to parents. RESULTS:Brain injury and severe ROP but not BPD correlated independently with poor outcome at 11 years of age. Among children who were free from BPD, brain injury, and severe ROP, 10% had a poor outcome. Corresponding rates with any 1, any 2, and all 3 neonatal morbidities were 19%, 58%, and 80%, respectively. Multivariate analysis revealed that brain injury and severe ROP were associated with high rates of consequences of chronic conditions. CONCLUSIONS: In infants born extremely preterm who survive to a postmenstrual age of 36 weeks, severe ROP and brain injury separately predict the risk of death or major disability at 11 years of age. Thus, continued research to determine how to prevent these complications of prematurity is critical.
Authors: Jessica Y Islam; Roberta L Keller; Judy L Aschner; Tina V Hartert; Paul E Moore Journal: Am J Respir Crit Care Med Date: 2015-07-15 Impact factor: 21.405
Authors: Yvonne E Vaucher; Myriam Peralta-Carcelen; Neil N Finer; Waldemar A Carlo; Marie G Gantz; Michele C Walsh; Abbot R Laptook; Bradley A Yoder; Roger G Faix; Abhik Das; Kurt Schibler; Wade Rich; Nancy S Newman; Betty R Vohr; Kimberly Yolton; Roy J Heyne; Deanne E Wilson-Costello; Patricia W Evans; Ricki F Goldstein; Michael J Acarregui; Ira Adams-Chapman; Athina Pappas; Susan R Hintz; Brenda Poindexter; Anna M Dusick; Elisabeth C McGowan; Richard A Ehrenkranz; Anna Bodnar; Charles R Bauer; Janell Fuller; T Michael O'Shea; Gary J Myers; Rosemary D Higgins Journal: N Engl J Med Date: 2012-12-27 Impact factor: 91.245
Authors: Karl C K Kuban; Robert M Joseph; Thomas M O'Shea; Elizabeth N Allred; Timothy Heeren; Laurie Douglass; Carl E Stafstrom; Hernan Jara; Jean A Frazier; Deborah Hirtz; Alan Leviton Journal: J Pediatr Date: 2016-03-19 Impact factor: 4.406
Authors: Jan Hau Lee; Christoph P Hornik; Daniela Testoni; Matthew M Laughon; C Michael Cotten; Ramiro S Maldonado; Marc R Belcastro; Reese H Clark; P Brian Smith Journal: Am J Perinatol Date: 2015-10-20 Impact factor: 3.079
Authors: Pia Lundgren; Elisabeth Stoltz Sjöström; Magnus Domellöf; Karin Källen; Gerd Holmström; Anna-Lena Hård; Lois E Smith; Chatarina Löfqvist; Ann Hellström Journal: PLoS One Date: 2013-09-12 Impact factor: 3.240