Aims: To describe perinatal factors associated with later morbidity among ext remely preterm children at 30 months of age corrected for prematurity. Populatio n: Of 308 surviving children born at ≤ 25 weeks gestation...Aims: To describe perinatal factors associated with later morbidity among ext remely preterm children at 30 months of age corrected for prematurity. Populatio n: Of 308 surviving children born at ≤ 25 weeks gestation in the United Kingdom and Ireland from March to December 1995, 283 (92% ) were evaluated at 30 month s of age corrected for prematurity. Methods: Cerebral palsy, severe motor disabi lity, and Bayley scores were used as dependent variables in sequential multiple regression analyses to identify factors associated with adverse outcomes. Result s: Adverse outcomes were consistently more common in boys. Factors related to pe rinatal illness, ultrasound evidence of brain injury, and treatment (particularl y postnatal steroids)- were associated with adverse motor outcomes (cerebral pa lsy, disability or Bayley psychomotor development index). Increasing duration of postnatal steroid treatment was associated with poor motor outcomes. A score wa s developed for severe motor disability with good negative predictive value. In contrast,mental development was associated with a broader range of factors: ethn ic group, maternal educational level, the use of antenatal steroids, and prolong ed rupture of membranes in addition to chronic lung disease. Conclusion: Male se x is a pervasive risk factor for poor outcome at extremely low gestations. Avoid able or effective treatment factors are identified, which may indicate the poten tial for improving outcome.展开更多
文摘Aims: To describe perinatal factors associated with later morbidity among ext remely preterm children at 30 months of age corrected for prematurity. Populatio n: Of 308 surviving children born at ≤ 25 weeks gestation in the United Kingdom and Ireland from March to December 1995, 283 (92% ) were evaluated at 30 month s of age corrected for prematurity. Methods: Cerebral palsy, severe motor disabi lity, and Bayley scores were used as dependent variables in sequential multiple regression analyses to identify factors associated with adverse outcomes. Result s: Adverse outcomes were consistently more common in boys. Factors related to pe rinatal illness, ultrasound evidence of brain injury, and treatment (particularl y postnatal steroids)- were associated with adverse motor outcomes (cerebral pa lsy, disability or Bayley psychomotor development index). Increasing duration of postnatal steroid treatment was associated with poor motor outcomes. A score wa s developed for severe motor disability with good negative predictive value. In contrast,mental development was associated with a broader range of factors: ethn ic group, maternal educational level, the use of antenatal steroids, and prolong ed rupture of membranes in addition to chronic lung disease. Conclusion: Male se x is a pervasive risk factor for poor outcome at extremely low gestations. Avoid able or effective treatment factors are identified, which may indicate the poten tial for improving outcome.
