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Characteristics of extremely low-birth-weight infant survivors with unimpaired outcomes at 30 months of age

Journal of Perinatology volume 33, pages 800–805 (2013)Cite this article

Subjects

Abstract

Objective:

To evaluate characteristics of unimpaired outcome in extremely low-birth-weight (ELBW) survivors.

Study design:

ELBW infants (n=714) with 30 months’ assessments were analyzed. Logistic regression was used to develop a model for the binary outcome of unimpaired versus impaired outcome.

Result:

Thirty-three percent of infants had an unimpaired outcome. Seventeen percent of ELBW survivors had a Bayley II Mental Developmental Index score of ⩾101 and 2% had a score of ⩾116. Female gender, use of antenatal steroids (ANS), maternal education ⩾high school and the absence of major neonatal morbidities were independent predictors of unimpaired outcome. The likelihood of an unimpaired outcome in the presence of major neonatal morbidities was higher in infants exposed to ANS.

Conclusion:

The majority of unimpaired ELBW survivors had cognitive scores shifted toward the lower end of the normal distribution. Exposure to ANS was associated with higher likelihood of an unimpaired outcome in infants with major neonatal morbidities.

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Acknowledgements

We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. The following investigators, in addition to those listed as authors, participated in this study: NRN Chair; Alan H Jobe, MD, PhD, University of Cincinnati. Brown University, Women & Infants Hospital of Rhode Island: William Oh, MD; Betty R Vohr, MD; Angelita Hensman, BSN RNC; Lucy Noel, RN; Barbara Alksninis, PNP; Martha R Leonard, BA; Rachel A Vogt, MD; Teresa M Leach, MEd CAES; Victoria E Watson, MS CAS. Case Western Reserve University, Rainbow Babies & Children’s Hospital: Avroy A Fanaroff, MD; Deanne Wilson-Costello, MD; Nancy S Newman, BA RN; Bonnie S Siner, RN; Harriet G Friedman, MA. Cincinnati Children’s Hospital Medical Center, University Hospital, and Good Samaritan Hospital: Edward F Donovan, MD; Jean Steichen, MD; Barb Alexander, RN; Cathy Grisby, BSN CCRC; Marcia Mersmann, RN; Holly Mincey, RN; Jody Shively, RN; Teresa L Gratton, PA. Emory University, Children’s Healthcare of Atlanta, Grady Memorial Hospital, and Emory Crawford Long Hospital: Barbara J Stoll, MD; Ira Adams-Chapman, MD; Ellen Hale, RN BS; Maureen Mulligan LaRossa, RN; Sheena Carter, PhD. Eunice Kennedy Shriver National Institute of Child Health and Human Development: Linda L Wright, MD; Elizabeth M McClure, MEd. Indiana University, University Hospital, Methodist Hospital, Riley Hospital for Children, and Wishard Health Services: Brenda B Poindexter, MD MS; James A Lemons, MD; Anna M Dusick, MD; Carolyn Lytle, MD; Darlene Kardatzke, MD; Marilyn Bull, MD; Greg Eaken, PhD; Lon G Bohnke, MS; Leslie Richard, RN; Diana D Appel, RN BSN; Dianne Herron, RN; Lucy Miller, RN BSN CCRC; Leslie Dawn Wilson, RN BSN. RTI International: W Kenneth Poole, PhD; Betty Hastings; Carolyn Petrie Huitema, MS; Scott E Schaefer, MS. Stanford University, Lucile Packard Children’s Hospital: David K Stevenson, MD; Susan R Hintz, MD MS; Barry E Fleisher, MD; M Bethany Ball, BS CCRC; Carol G Kuelper, PhD; Julie C Lee, PhD; Joan M Baran, PhD; Lori E Bond, PhD; Nicholas St. John, PhD; Renee P Pyle, PhD. University of Alabama at Birmingham Health System and Children’s Hospital of Alabama: Waldemar A Carlo, MD; Myriam Peralta-Carcelen, MD; Monica V Collins, RN BSN MaEd; Shirley S Cosby, RN BSN; Vivien A Phillips, RN BSN; Fred J Biasini, PhD; Kirstin J Bailey, PhD; Richard V Rector, PhD; Stephanie A Chopko, PhD. University of California – San Diego Medical Center and Sharp Mary Birch Hospital for Women: Neil N Finer, MD; Yvonne E Vaucher, MD MPH; Maynard R Rasmussen MD; Kathy Arnell, RN; Martha G Fuller, RN MSN; Donna Posin, OTR/L MPA. University of Miami Holtz Children’s Hospital: Shahnaz Duara, MD; Charles R Bauer, MD; Ruth Everett, RN MSN; Alexis N Diaz, BA; Elaine O Mathews, RN; Kasey Hamlin-Smith, PhD; Lisa Jean-Gilles, BA; Maria Calejo, MS; Silvia M Frade, BA; Silvia Hiriart-Fajardo, MD; Yamiley Gideon, BA. University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, and Children’s Medical Center Dallas: Abbot R Laptook, MD; R Sue Broyles, MD; Walid A Salhab, MD; Roy J Heyne, MD; Sally Adams, PNP; Cathy Boatman, MS CIMI; Cristin Dooley, MS; Alicia Guzman; Elizabeth Heyne, PA; Jackie F Hickman, RN; Linda Madden, PNP; Susie Madison, RN. Wayne State University, Hutzel Women’s Hospital, and Children’s Hospital of Michigan: Seetha Shankaran, MD; Yvette Johnson, MD; Rebecca Bara, RN BSN; Geraldine Muran, RN BSN; Deborah Kennedy, RN BSN; Laura Goldston, MA. Yale University and Yale-New Haven Children’s Hospital: Richard A Ehrenkranz, MD; Patricia Gettner, RN; Monica Konstantino, RN; Elaine Romano, RN BSN; Nancy Close, PhD; Walter Gilliam, PhD. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; Grants U10 HD21364, U10 HD21385, U10 HD21397, U10 HD27851, U10 HD27853, U10 HD27856, U10 HD27871, U10 HD27880U10 HD27904, U10 HD34216, U10 HD36790, U10 HD40461, U10 HD40689) and The National Institutes of Health (General Clinical Research Center Grants M01 RR32, M01 RR39, M01 RR70, M01 RR80, M01 RR633, M01 RR750, M01 RR6022, M01 RR8084 and M01 RR16587) provided grant support for the Neonatal Research Network’s Glutamine Study.

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Authors and Affiliations

  1. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    P Kumar

  2. Department of Pediatrics, Wayne State University, Detroit, MI, USA

    S Shankaran & A Pappas

  3. Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA

    N Ambalavanan

  4. Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC, USA

    D E Kendrick

  5. Department of Pediatrics, Brown University, Providence, RI, USA

    B R Vohr

  6. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

    B B Poindexter

  7. Statistics and Epidemiology Unit, RTI International, Rockville, MD, USA

    A Das

  8. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    R D Higgins

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  1. P Kumar
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Correspondence to P Kumar.

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Kumar, P., Shankaran, S., Ambalavanan, N. et al. Characteristics of extremely low-birth-weight infant survivors with unimpaired outcomes at 30 months of age. J Perinatol 33, 800–805 (2013). https://doi.org/10.1038/jp.2013.71

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