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Updated: Aug 26, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
[Mid and long-term neurological prognosis of preterm infants less than 28 weeks gestational age]
Insights
Extremely premature infants face high neonatal mortality, with factors like lack of prenatal steroids and male gender increasing risk. Survivors often experience long-term neurological issues, highlighting the need for continuous high-risk infant care.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Perinatal Medicine
Context:
- Long-term outcomes for extremely premature infants (born before 28 weeks gestation) are challenging to study due to heterogeneous data.
- Variations in recruitment, obstetrical management, and treatment withdrawal criteria complicate outcome analysis.
- This study examines the 6-year outcomes of 204 extremely premature infants born between 1992 and 1997.
Purpose:
- To analyze the neonatal mortality and long-term neurodevelopmental outcomes of extremely premature infants.
- To identify predictive factors for neonatal death and neurodevelopmental impairments, including cerebral palsy (CP) and low IQ.
- To underscore the necessity of early and ongoing care for high-risk premature infants.
Summary:
- Neonatal mortality was 40.2%, associated with absence of prenatal steroids, male gender, elevated birth lactate, and pulmonary complications.
- Among 114 survivors, 14.9% developed cerebral palsy or low IQ, while 27.2% had minor disorders and 57.9% were normal.
- Major brain lesions, elevated birth lactate, and multiple pregnancies predicted CP. Minor neurological, cognitive, and psychological disorders were also observed.
Impact:
- Identifies critical risk factors for neonatal mortality and long-term neurodevelopmental deficits in extremely premature infants.
- Provides valuable data for clinicians and researchers managing high-risk neonatal populations.
- Emphasizes the importance of comprehensive, continuous care pathways for extremely premature infants to mitigate adverse outcomes.
Abstract:
The study of the long-term outcome of extremely premature babies is specially difficult because data in the literature is very heterogeneous. Recruitment (inborn, outborn), type of obstetrical management, and criteria and means used for interrupting curative treatment have varied greatly. We present the outcome of 204 infants born before 28 weeks of gestation between 1992 and 1997. The minimal follow up is 6 years. 82 infants (40.2%) died during the neonatal period. Significantly associated with neonatal death were absence of prenatal steroid course, male gender, elevated lactic acid at birth, and occurrence of pulmonary complications. When major neurological lesions (ventricular hemorrage stage III or IV and kryptic leucomalacia) developed, most infants died following a decision to stop active treatment. Out of the 114 survivors, 17 (14.9%) developed cerebral palsy (CP) or a low IQ. 31 (27.2%) had minor disorders, 66 (57.9%) were completely normal. The predictive factors of CP were major brain lesions, elevated lactic acid at the time of birth and multiple pregnancy. We also detail the minor neurological sequelae, cognitive behavioral, and psychological disorders observed in this population of extremely premature children and discuss the need for early and continuous care for these high risk babies.
