Background: Preterm delivery is associated with an increased risk of cerebral palsy (CP). The greatest risk is for infants born < 28 weeks’gestation. Aims: To identify significant neonatal risk factors for CP and ...Background: Preterm delivery is associated with an increased risk of cerebral palsy (CP). The greatest risk is for infants born < 28 weeks’gestation. Aims: To identify significant neonatal risk factors for CP and explore the interactions between antenatal and neonatal risk factors, among extremely preterm infants of 27 weeks’gestation or less. Study Design: Nested case control design. Methods: Infants born between 1989 and 1996, at 24-27weeks’gestation,were evaluated: 30 with CP at 2 years corrected age and 120 control infants matched for gestation age. Neonatal variables were compared using matched analyses with the interaction between antenatal and neonatal factors being examined using logistic regression analyses. Results: Risk factors for CP on matched analyses included patent ductus arteriosus requiring surgical ligation, peri-intraventricular haemorrhage, moderate to severe ventricular dilatation, periventricular leukomalacia (PVL) and need for home oxygen. Independent neonatal predictors were ventricular dilatation (OR 7.3; 95%CI 1.6, 32.3), PVL (OR 29.8; 95%CI 5.6, 159.1) and home oxygen use (OR 3.4; 95%CI 1.2, 9.4). No interaction terms in the logistic models were significant between the previously identified pregnancy risk factors of absence of antenatal steroids and intrauterine growth restriction and the neonatal risk factors. Conclusions: PVL is the most powerful independent predictor of CP in extremely preterm infants of 27 weeks’gestation or less and appears to be uninfluenced by antenatal factors.展开更多
Aims: To examine the associations between being overweight and behavioural pro blems at ages 5 and 14. Methods: Birth cohort study of 2875 individuals who were born in Brisbane between 1981 and 1984 and who were follo...Aims: To examine the associations between being overweight and behavioural pro blems at ages 5 and 14. Methods: Birth cohort study of 2875 individuals who were born in Brisbane between 1981 and 1984 and who were followed up at ages 5 and 1 4 years. Behavioural problems were defined as scoring above the 90th centile on Achenbach’s child behavioural checklist. Results: In cross-sectional analyses there was no association between being overweight and behavioural problems in ei ther females at age 5. At age 14 females who were overweight were more likely th an those who were normal weight to experience behavioural problems. However, the re was no association between being overweight and behavioural problems at age 1 4 among males. The prevalence of behavioural problems increased linearly across the di stribution of body mass index in females at age 14. In prospective analyses, amo ng participants who had no behavioural problems at age 5, there was no associati on between being overweight at age 5 and behavioural problems at age 14 in eithe r sex. Females who were overweight at age 5 and normal weight at age 14 had redu ced odds of behavioural problems at age 14. Conclusions: Among adolescent female s there is a positive linear association between body size and behavioural probl ems. However, no such association was found in adolescent males, or in either se x at age 5 years, and in prospective analyses being overweight at age 5 was not associated with behavioural problems in either sex at age 14.展开更多
文摘Background: Preterm delivery is associated with an increased risk of cerebral palsy (CP). The greatest risk is for infants born < 28 weeks’gestation. Aims: To identify significant neonatal risk factors for CP and explore the interactions between antenatal and neonatal risk factors, among extremely preterm infants of 27 weeks’gestation or less. Study Design: Nested case control design. Methods: Infants born between 1989 and 1996, at 24-27weeks’gestation,were evaluated: 30 with CP at 2 years corrected age and 120 control infants matched for gestation age. Neonatal variables were compared using matched analyses with the interaction between antenatal and neonatal factors being examined using logistic regression analyses. Results: Risk factors for CP on matched analyses included patent ductus arteriosus requiring surgical ligation, peri-intraventricular haemorrhage, moderate to severe ventricular dilatation, periventricular leukomalacia (PVL) and need for home oxygen. Independent neonatal predictors were ventricular dilatation (OR 7.3; 95%CI 1.6, 32.3), PVL (OR 29.8; 95%CI 5.6, 159.1) and home oxygen use (OR 3.4; 95%CI 1.2, 9.4). No interaction terms in the logistic models were significant between the previously identified pregnancy risk factors of absence of antenatal steroids and intrauterine growth restriction and the neonatal risk factors. Conclusions: PVL is the most powerful independent predictor of CP in extremely preterm infants of 27 weeks’gestation or less and appears to be uninfluenced by antenatal factors.
文摘Aims: To examine the associations between being overweight and behavioural pro blems at ages 5 and 14. Methods: Birth cohort study of 2875 individuals who were born in Brisbane between 1981 and 1984 and who were followed up at ages 5 and 1 4 years. Behavioural problems were defined as scoring above the 90th centile on Achenbach’s child behavioural checklist. Results: In cross-sectional analyses there was no association between being overweight and behavioural problems in ei ther females at age 5. At age 14 females who were overweight were more likely th an those who were normal weight to experience behavioural problems. However, the re was no association between being overweight and behavioural problems at age 1 4 among males. The prevalence of behavioural problems increased linearly across the di stribution of body mass index in females at age 14. In prospective analyses, amo ng participants who had no behavioural problems at age 5, there was no associati on between being overweight at age 5 and behavioural problems at age 14 in eithe r sex. Females who were overweight at age 5 and normal weight at age 14 had redu ced odds of behavioural problems at age 14. Conclusions: Among adolescent female s there is a positive linear association between body size and behavioural probl ems. However, no such association was found in adolescent males, or in either se x at age 5 years, and in prospective analyses being overweight at age 5 was not associated with behavioural problems in either sex at age 14.
