Prediction of Cerebral Palsy or Death among Preterm Infants Who Survive the Neonatal Period
Thieme. All rights reserved..
OBJECTIVE: To assess whether neonatal morbidities evident by the time of hospital discharge are associated with subsequent cerebral palsy (CP) or death.
STUDY DESIGN: This is a secondary analysis of data from a multicenter placebo-controlled trial of magnesium sulfate for the prevention of CP. The association between prespecified intermediate neonatal outcomes (n = 11) and demographic and clinical factors (n = 10) evident by the time of discharge among surviving infants (n = 1889) and the primary outcome of death or moderate/severe CP at age 2 (n = 73) was estimated, and a prediction model was created.
RESULTS: Gestational age in weeks at delivery (odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.67-0.83), grade III or IV intraventricular hemorrhage (IVH) (OR: 5.3, CI: 2.1-13.1), periventricular leukomalacia (PVL) (OR: 46.4, CI: 20.6-104.6), and male gender (OR: 2.5, CI: 1.4-4.5) were associated with death or moderate/severe CP by age 2. Outcomes not significantly associated with the primary outcome included respiratory distress syndrome, bronchopulmonary dysplasia, seizure, necrotizing enterocolitis, neonatal hypotension, 5-minute Apgar score, sepsis, and retinopathy of prematurity. Using all patients, the receiver operating characteristic curve for the final prediction model had an area under the curve of 0.84 (CI: 0.78-0.89). Using these data, the risk of death or developing CP by age 2 can be calculated for individual surviving infants.
CONCLUSION: IVH and PVL were the only neonatal complications evident at discharge that contributed to an individual infant's risk of the long-term outcomes of death or CP by age 2. A model that includes these morbidities, gestational age at delivery, and gender is predictive of subsequent neurologic sequelae.
KEY POINTS: · Factors known at hospital discharge are identified which are independently associated with death or CP by age 2.. · A model was created and validated using these findings to counsel parents.. · The risk of death or CP can be calculated at the time of hospital discharge.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
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| Enthalten in: |
American journal of perinatology - 41(2024), 6 vom: 24. Apr., Seite 783-789 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Peaceman, Alan M [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 12.04.2024 Date Revised 15.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1055/a-1788-6281 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM337841799 |
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| 041 | |a eng | ||
| 100 | 1 | |a Peaceman, Alan M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prediction of Cerebral Palsy or Death among Preterm Infants Who Survive the Neonatal Period |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 12.04.2024 | ||
| 500 | |a Date Revised 15.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Thieme. All rights reserved. | ||
| 520 | |a OBJECTIVE: To assess whether neonatal morbidities evident by the time of hospital discharge are associated with subsequent cerebral palsy (CP) or death | ||
| 520 | |a STUDY DESIGN: This is a secondary analysis of data from a multicenter placebo-controlled trial of magnesium sulfate for the prevention of CP. The association between prespecified intermediate neonatal outcomes (n = 11) and demographic and clinical factors (n = 10) evident by the time of discharge among surviving infants (n = 1889) and the primary outcome of death or moderate/severe CP at age 2 (n = 73) was estimated, and a prediction model was created | ||
| 520 | |a RESULTS: Gestational age in weeks at delivery (odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.67-0.83), grade III or IV intraventricular hemorrhage (IVH) (OR: 5.3, CI: 2.1-13.1), periventricular leukomalacia (PVL) (OR: 46.4, CI: 20.6-104.6), and male gender (OR: 2.5, CI: 1.4-4.5) were associated with death or moderate/severe CP by age 2. Outcomes not significantly associated with the primary outcome included respiratory distress syndrome, bronchopulmonary dysplasia, seizure, necrotizing enterocolitis, neonatal hypotension, 5-minute Apgar score, sepsis, and retinopathy of prematurity. Using all patients, the receiver operating characteristic curve for the final prediction model had an area under the curve of 0.84 (CI: 0.78-0.89). Using these data, the risk of death or developing CP by age 2 can be calculated for individual surviving infants | ||
| 520 | |a CONCLUSION: IVH and PVL were the only neonatal complications evident at discharge that contributed to an individual infant's risk of the long-term outcomes of death or CP by age 2. A model that includes these morbidities, gestational age at delivery, and gender is predictive of subsequent neurologic sequelae | ||
| 520 | |a KEY POINTS: · Factors known at hospital discharge are identified which are independently associated with death or CP by age 2.. · A model was created and validated using these findings to counsel parents.. · The risk of death or CP can be calculated at the time of hospital discharge | ||
| 650 | 4 | |a Controlled Clinical Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 700 | 1 | |a Mele, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Rouse, Dwight J |e verfasserin |4 aut | |
| 700 | 1 | |a Leveno, Kenneth J |e verfasserin |4 aut | |
| 700 | 1 | |a Mercer, Brian M |e verfasserin |4 aut | |
| 700 | 1 | |a Varner, Michael W |e verfasserin |4 aut | |
| 700 | 1 | |a Reddy, Uma M |e verfasserin |4 aut | |
| 700 | 1 | |a Wapner, Ronald J |e verfasserin |4 aut | |
| 700 | 1 | |a Sorokin, Yoram |e verfasserin |4 aut | |
| 700 | 1 | |a Thorp, John M |e verfasserin |4 aut | |
| 700 | 1 | |a Ramin, Susan M |e verfasserin |4 aut | |
| 700 | 1 | |a Malone, Fergal D |e verfasserin |4 aut | |
| 700 | 1 | |a O'Sullivan, Mary J |e verfasserin |4 aut | |
| 700 | 1 | |a Dudley, Donald J |e verfasserin |4 aut | |
| 700 | 1 | |a Caritis, Steve N |e verfasserin |4 aut | |
| 700 | 0 | |a Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network |e verfasserin |4 aut | |
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