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Multivariate risks among extremely premature infants

M E Msall1, G M Buck, B T Rogers

  • 1Department of Pediatrics, Robert Warner Rehabilitation Center, Buffalo, NY 14209.

Journal of Perinatology : Official Journal of the California Perinatal Association
|January 1, 1994
PubMed
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Extremely premature infants face significant mortality and morbidity risks. Key factors include low birth weight, severe brain bleeds, low Apgar scores, male sex, and lack of surfactant therapy.

Area of Science:

  • Neonatalogy
  • Pediatric Neurology
  • Public Health

Background:

  • The surfactant era has improved outcomes for premature infants, but mortality and morbidity remain significant concerns.
  • Identifying specific risk factors is crucial for developing targeted interventions to improve long-term outcomes for extremely premature infants.

Purpose of the Study:

  • To identify significant risk factors associated with mortality and major impairments in extremely premature infants born during the surfactant era.
  • To provide data that can inform the development of strategies aimed at optimizing the long-term health and development of this vulnerable population.

Main Methods:

  • A cohort of 194 infants born at < 29 weeks' gestation between 1983 and 1986 was studied.
  • Mortality data were collected, and survivors underwent blinded neurodevelopmental assessments at a mean age of 52 months.

Related Experiment Videos

  • Logistic regression analysis was used to identify significant risk factors for mortality and major impairments.

    • Main Results:

    • Five significant risk factors for mortality were identified: grade III/IV intraventricular hemorrhage, birth weight < 800 gm, 5-minute Apgar score ≤ 3, male sex, and absence of surfactant therapy.
    • Significant risk factors for major impairment included sepsis, male sex, and nonwhite race.
    • Hydrocephalus requiring shunting was a strong predictor of cerebral palsy and neonatal retardation. Nonwhite race, sepsis, and male sex were also significant risk factors for mental retardation.

    Conclusions:

    • Specific factors such as intraventricular hemorrhage, low birth weight, and Apgar scores are critical predictors of mortality in extremely premature infants.
    • Sepsis, male sex, and nonwhite race are significant risk factors for major neurodevelopmental impairments, including mental retardation and cerebral palsy.
    • Understanding these risk factors is essential for developing targeted interventions to improve survival and long-term outcomes for extremely premature infants.