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Timing of insults causing abnormal outcome in preterm infants 1989-1992
S Morikawa1, A Itakura, F Hayakawa
1Department of Obstetrics and Gynecology, Nagoya University School of Medicine, Japan.
Insights
Timing of brain insults significantly impacts preterm infant outcomes. Insults before 28 weeks increased mortality, while later insults were linked to intrauterine injuries and fetal distress, affecting development.
Area of Science:
- Neonatal Neurology
- Developmental Pediatrics
- Perinatal Medicine
Background:
- Preterm infants face risks of brain injury.
- The timing of brain insults is crucial for determining outcomes.
- Understanding insult timing aids in predicting developmental trajectories.
Purpose of the Study:
- To investigate the influence of the timing of brain insults on preterm infants.
- To correlate insult timing with mortality and abnormal development.
- To identify specific injury patterns based on gestational age.
Main Methods:
- Study included 131 preterm infants.
- Brain insult timing assessed via EEG and clinical data.
- Developmental assessment up to 48 months corrected age.
Main Results:
- Mortality was higher in infants born before 28 weeks (39%) vs. after (4%).
- Abnormal development rates were similar between groups (16% vs. 13%).
- Intrauterine injuries were more common in infants born after 28 weeks (P < 0.05).
Conclusions:
- Intrauterine brain insults are a significant cause of mortality and abnormal development in preterm infants born after 28 weeks.
- Gestational age at birth is a critical factor in the type and impact of brain insults.
- Early identification of insult timing can inform clinical management and prognostication.
Objective:
The purpose of this study was to clarify the influence of timing of brain insults causing abnormal outcome in preterm infants.
Methods:
One hundred and thirty-one preterm infants were examined. The timing of brain insult was estimated from EEG or clinical findings. Development was assessed until a corrected age of 48 months.
Results:
39% and 4% of infants, respectively, born before and after the 28-week time point subsequently died (P < 0.05). Abnormal development was observed in 16% of the first group and 13% of the second (N.S.). None of those born before 28 weeks showed intrauterine injuries while nine of the infants which were born after this time showed intrauterine injuries (P < 0.05). Fetal distress was noted in all infants suffering neonatal death born after 28 weeks.
Conclusion:
Intrauterine brain insult was concluded to be the cause of neonatal death or abnormal development in many infants born after 28 weeks.