Original Article

Journal of Perinatology (2005) 25, 210–215. doi:10.1038/sj.jp.7211228 Published online 2 December 2004

Risk Factors for Adverse Neurodevelopment in Extremely Low Birth Weight Infants with Normal Neonatal Cranial Ultrasound

Venkatesh Sampath MBBS, MRCPCh1, Jennifer Bowen MBBS, FRACP1 and Frances Gibson PhD1

1Department of Neonatal Medicine (V.S., J.B., F.G.), Royal North Shore Hospital, Sydney

Correspondence: Venkatesh Sampath, MBBS, MRCPCh, Department of Neonatology, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA

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Abstract

OBJECTIVES:

 

To determine risk factors associated with adverse developmental outcome at 5 years in extremely low birth weight infants or extremely premature infants (<28 weeks) with normal neonatal cranial ultrasounds.

DESIGN/METHODS:

 

Data were collected prospectively on 152 infants with gestation <28 weeks or birth-weight <1000 g. Infants were grouped into those with normal development, mild-to-moderate impairment (IQ 70 to 84, or hearing loss 30 to 89 dB, visual acuity 6/18 to 6/60, or mild/moderate cerebral palsy (CP)) and severe impairment (IQ <70, hearing loss greater than or equal to90 dB, visual acuity <6/60, or severe CP).

RESULTS:

 

Five-year outcomes were available for 144/152 children (95%). In all, 89 (62%) infants had normal development, 39 (27%) had mild–moderate impairment and 16 (11%) had severe impairment. On multivariate logistic regression analysis, factors associated with developmental impairment were serum bilirubin greater than or equal to200 mumol/l (odds ratio (OR) – 4.06, p=0.003) and retinopathy of prematurity (ROP) (OR–1.6, p=0.03).

CONCLUSIONS:

 

A serum bilirubin greater than or equal to200 mumol/l and presence of ROP are postnatal risk factors associated with an adverse developmental outcome in infants with normal cranial ultrasounds.

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