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Published on: November 20, 2015
Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages
U Kiechl-Kohlendorfer1, E Ralser, U Pupp Peglow
1Department of Paediatrics, Division of Neonatology, Neuropaediatrics and Metabolic Disorders, Innsbruck Medical University, Innsbruck, Austria. ursula.kohlendorfer@i-med.ac.at
Aim:
Assessment of risk predictors for adverse neurodevelopmental outcome at 1 year of age in preterm infants with a gestational age <30 weeks (Group I) and 30-32 weeks (Group II).
Methods:
Between January 2003 and December 2006, we prospectively enrolled 310 live-born infants between 23 and 32 weeks of gestation. The association between candidate risk factors and delayed motor or mental development (Bayley Scales of infant development II; psychomotor or mental developmental index <85) was analysed by means of logistic regression analysis.
Results:
Two hundred and fifty infants were eligible for follow-up, and 205 (82.0%) completed the follow-up visit. Intracerebral haemorrhage, small for gestational age and late-onset sepsis were associated with an increased risk for delayed development in Group I (p < 0.05, each). Premature rupture of membranes was a risk condition relevant to Group II. Antenatal steroids were associated with a decreased risk of neurodevelopmental delay in both groups.
Conclusion:
This study identified distinct risk factors for adverse outcome in preterm infants of lower (<30 weeks) and higher (30-32 weeks) gestational age. In the lower gestational age group, neonatal risk predictors are most important. Antenatal steroids appear to decrease the risk for adverse outcome in both age groups.
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