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PMID: 23272671 Published · epublish English Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Outcome at two years of age in a Swiss national cohort of extremely preterm infants born between 2000 and 2008.

BMC pediatrics ·Vol. 12 ·2012-12-28 ·Pages 198

Schlapbach LJ, Adams M, Proietti E, Aebischer M, Grunt S, Borradori-Tolsa C, Bickle-Graz M, Bucher HU, Latal B, Natalucci G, Swiss Neonatal Network & Follow-up Group

Abstract

While survival rates of extremely preterm infants have improved over the last decades, the incidence of neurodevelopmental disability (ND) in survivors remains high. Representative current data on the severity of disability and of risk factors associated with poor outcome in this growing population are necessary for clinical guidance and parent counselling. Prospective longitudinal multicentre cohort study of preterm infants born in Switzerland between 24(0/7) and 27(6/7) weeks gestational age during 2000-2008. Mortality, adverse outcome (death or severe ND) at two years, and predictors for poor outcome were analysed using multilevel multivariate logistic regression. Neurodevelopment was assessed using Bayley Scales of Infant Development II. Cerebral palsy was graded after the Gross Motor Function Classification System. Of 1266 live born infants, 422 (33%) died. Follow-up information was available for 684 (81%) survivors: 440 (64%) showed favourable outcome, 166 (24%) moderate ND, and 78 (11%) severe ND. At birth, lower gestational age, intrauterine growth restriction and absence of antenatal corticosteroids were associated with mortality and adverse outcome (p < 0.001). At 36(0/7) weeks postmenstrual age, bronchopulmonary dysplasia, major brain injury and retinopathy of prematurity were the main predictors for adverse outcome (p < 0.05). Survival without moderate or severe ND increased from 27% to 39% during the observation period (p = 0.02). In this recent Swiss national cohort study of extremely preterm infants, neonatal mortality was determined by gestational age, birth weight, and antenatal corticosteroids while neurodevelopmental outcome was determined by the major neonatal morbidities. We observed an increase of survival without moderate or severe disability.

MeSH Terms
Child, Preschool Developmental Disabilities/epidemiology,etiology,mortality Female Follow-Up Studies Humans Infant, Extremely Premature Infant, Newborn Infant, Premature, Diseases/epidemiology,etiology,mortality Logistic Models Male Multivariate Analysis Nervous System Diseases/epidemiology,etiology,mortality Prospective Studies Psychological Tests Registries Risk Factors Severity of Illness Index Switzerland/epidemiology
Authors & Affiliations
11 authors, click to expand affiliations / ORCID
Schlapbach Luregn J
Neonatal and Paediatric Intensive Care Unit, Department of Paediatrics, University of Bern, Bern, Switzerland.
Adams Mark
Proietti Elena
Aebischer Maude
Grunt Sebastian
Borradori-Tolsa Cristina
Bickle-Graz Myriam
Bucher Hans Ulrich
Latal Beatrice
Natalucci Giancarlo
Swiss Neonatal Network & Follow-up Group
Investigators
32 investigators, click to expand
Zeilinger G
Capone A
Steiner F
Schulzke S
Weber P
Ramelli G P
Nelle M
Steinlin M
Grunt S
Hassink R
Bär W
Keller E
Killer Ch
Fuhrer K
Tolsa J-F
Bickle-Graz M
Pfister R E
Huppi P S
Borradori-Tolsa C
Berger T M
Schmitt-Mechelke T
Pezzoli V
Ecoffey M
Mueller A
Malzacher A
Micallef J P
Schaefer Ch
von Rhein M
Arlettaz Mieth R
Bernet V
Latal B
Natalucci G
References (36)
36 references, click to expand
  1. The spectrum of leukomalacia using cranial ultrasound.
    Behav Brain Res. 1992 Jul 31;49(1):1-6 PMID: 1388792
  2. Permissive hypercapnia to decrease lung injury in ventilated preterm neonates.
    Semin Fetal Neonatal Med. 2009 Feb;14(1):21-7 PMID: 18974027
  3. Caesarean or vaginal delivery for preterm very-low-birth weight (< or =1,250 g) infant: experience from a district general hospital in UK.
    Arch Gynecol Obstet. 2008 Mar;277(3):207-12 PMID: 17694314
  4. Neurocognitive outcome after very preterm birth.
    Arch Dis Child Fetal Neonatal Ed. 2004 May;89(3):F224-8 PMID: 15102725
  5. Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps.
    J Pediatr. 1983 Aug;103(2):273-7 PMID: 6875724
  6. A report: the definition and classification of cerebral palsy April 2006.
    Dev Med Child Neurol Suppl. 2007 Feb;109:8-14 PMID: 17370477
  7. The adverse neuro-developmental effects of postnatal steroids in the preterm infant: a systematic review of RCTs.
    BMC Pediatr. 2001;1:1 PMID: 11248841
  8. Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months: results from the trial of indomethacin prophylaxis in preterms.
    JAMA. 2003 Mar 5;289(9):1124-9 PMID: 12622582
  9. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.
    Pediatrics. 2010 Sep;126(3):443-56 PMID: 20732945
  10. Preterm outcome table (POT): a simple tool to aid counselling parents of very preterm infants.
    Aust N Z J Obstet Gynaecol. 2006 Jun;46(3):189-92 PMID: 16704470
  11. Chronic conditions, functional limitations, and special health care needs of school-aged children born with extremely low-birth-weight in the 1990s.
    JAMA. 2005 Jul 20;294(3):318-25 PMID: 16030276
  12. Investigating the variations in survival rates for very preterm infants in 10 European regions: the MOSAIC birth cohort.
    Arch Dis Child Fetal Neonatal Ed. 2009 May;94(3):F158-63 PMID: 18805823
  13. Histological chorioamnionitis and neurodevelopmental outcome in preterm infants.
    J Perinatol. 2013 Jan;33(1):70-5 PMID: 22555781
  14. Intensive care for extreme prematurity--moving beyond gestational age.
    N Engl J Med. 2008 Apr 17;358(16):1672-81 PMID: 18420500
  15. Using a count of neonatal morbidities to predict poor outcome in extremely low birth weight infants: added role of neonatal infection.
    Pediatrics. 2009 Jan;123(1):313-8 PMID: 19117897
  16. Neurologic and developmental disability at six years of age after extremely preterm birth.
    N Engl J Med. 2005 Jan 6;352(1):9-19 PMID: 15635108
  17. Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis.
    JAMA. 2002 Aug 14;288(6):728-37 PMID: 12169077
  18. Significance of prenatal, perinatal and postnatal factors in the development of AGA preterm infants at five to seven years.
    Dev Med Child Neurol. 1989 Aug;31(4):440-56 PMID: 2680687
  19. Bronchopulmonary dysplasia.
    Am J Respir Crit Care Med. 2001 Jun;163(7):1723-9 PMID: 11401896
  20. Outcomes of children of extremely low birthweight and gestational age in the 1990's.
    Early Hum Dev. 1999 Jan;53(3):193-218 PMID: 10088988
  21. Poor predictive validity of the Bayley Scales of Infant Development for cognitive function of extremely low birth weight children at school age.
    Pediatrics. 2005 Aug;116(2):333-41 PMID: 16061586
  22. Prediction of death for extremely premature infants in a population-based cohort.
    Pediatrics. 2010 Sep;126(3):e644-50 PMID: 20713479
  23. WITHDRAWN: Prophylactic corticosteroids for preterm birth.
    Cochrane Database Syst Rev. 2007 Jul 18;(3):CD000065 PMID: 17636582
  24. The International Classification of Retinopathy of Prematurity revisited.
    Arch Ophthalmol. 2005 Jul;123(7):991-9 PMID: 16009843
  25. Outcomes at age 2 years of infants < 28 weeks' gestational age born in Victoria in 2005.
    J Pediatr. 2010 Jan;156(1):49-53.e1 PMID: 19783004
  26. Outcome at 5 years of age of children 23 to 27 weeks' gestation: refining the prognosis.
    Pediatrics. 2001 Jul;108(1):134-41 PMID: 11433066
  27. Neurologic and developmental disability after extremely preterm birth. EPICure Study Group.
    N Engl J Med. 2000 Aug 10;343(6):378-84 PMID: 10933736
  28. Impact of cesarean section on neonatal mortality rates among very preterm infants in the United States, 2000-2003.
    Pediatrics. 2008 Aug;122(2):285-92 PMID: 18676545
  29. Trends in neonatal morbidity and mortality for very low birthweight infants.
    Am J Obstet Gynecol. 2007 Feb;196(2):147.e1-8 PMID: 17306659
  30. Impact of sepsis on neurodevelopmental outcome in a Swiss National Cohort of extremely premature infants.
    Pediatrics. 2011 Aug;128(2):e348-57 PMID: 21768312
  31. Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth.
    Lancet. 2008 Jan 12;371(9607):164-75 PMID: 18191687
  32. Development and reliability of a system to classify gross motor function in children with cerebral palsy.
    Dev Med Child Neurol. 1997 Apr;39(4):214-23 PMID: 9183258
  33. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging.
    Ann Surg. 1978 Jan;187(1):1-7 PMID: 413500
  34. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection.
    JAMA. 2004 Nov 17;292(19):2357-65 PMID: 15547163
  35. Population based trends in mortality, morbidity and treatment for very preterm- and very low birth weight infants over 12 years.
    BMC Pediatr. 2012 Feb 22;12:17 PMID: 22356724
  36. Learning disabilities in children with very low birthweight: prevalence, neuropsychological correlates, and educational interventions.
    J Learn Disabil. 2005 Mar-Apr;38(2):130-41 PMID: 15813595
Article Info
Journal
BMC pediatrics
Abbr.
BMC Pediatr
ISSN
1471-2431
DOI
10.1186/1471-2431-12-198
Published
2012-12-28
Epub
2012-00-28
Pages
198
Language
English
Region
England
NLM ID
100967804
PMCID
PMC3546845
Subset
IM
External Links
PubMed source DOI: 10.1186/1471-2431-12-198 PMC Full Text View journal details
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