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Outcome of infants born at 24-26 weeks' gestation: II. Neurodevelopmental outcome
R E Piecuch1, C H Leonard, B A Cooper
1Department of Pediatrics, University of California, San Francisco, 94143, USA. bpiecuch@peds.ucsf.edu
Objective:
To assess the neurodevelopmental outcome of infants born at 24-26 weeks' gestation.
Methods:
One hundred thirty-eight nonanomalous infants were born at our hospital after pregnancies of 24-26 weeks' gestation between 1990 and 1994. Ninety-four infants survived to discharge and 86 were followed in a nursery follow-up program for outcome. Associations between gestational age and neurodevelopmental outcome and risk factors and outcome were analyzed. Mean age at follow-up was 32 months.
Results:
The frequency of cerebral palsy did not differ significantly in the three groups (11, 20, and 11% at 24, 25, and 26 weeks, respectively). The incidence of normal cognitive outcome was associated significantly with gestational age at birth (28, 47, and 71% normal at 24, 25, and 26 weeks, respectively). Poor neurologic outcome was associated with the medical risk factor of intracranial hemorrhage grade 3 or 4 or periventricular leukomalacia. Poor cognitive outcome was correlated with both medical and social risk factors; however, there was an association between poor cognitive outcome and lower gestational age (P < .05), regardless of the relationships of any other risk factors to cognitive outcome.
Conclusion:
Although the incidence of cerebral palsy was low in these three groups, the high percentage of infants born at 24 and 25 weeks' gestation with cognitive deficits is concerning.