Portal de Periódicos da CAPES

Prediction of Late Death or Disability at Age 5 Years Using a Count of 3 Neonatal Morbidities in Very Low Birth Weight Infants

2015; Elsevier BV; Volume: 167; Issue: 5 Linguagem: Inglês

10.1016/j.jpeds.2015.07.067

1097-6833

Barbara Schmidt, Robin S. Roberts, Peter G. Davis, Lex W. Doyle, Elizabeth Asztalos, Gillian Opie, Aïda Bairam, Alfonso Solimano, Shmuel Arnon, Reginald S. Sauve, Barbara Schmidt, Judy D’Ilario, Janice Cairnie, Joanne Dix, Beth Adams, Erin M. Warriner, Mee-Hai Marie Kim, Peter J. Anderson, Peter G. Davis, Lex W. Doyle, Brenda Argus, Catherine Callanan, Noni Davis, Julianne Duff, Marion McDonald, Elizabeth Asztalos, Denise Hohn, Maralyn Lacy, Ross Haslam, Christopher Barnett, Louise Goodchild, Rosslyn Marie Lontis, Simon Fraser, Julie Keng, Kerryn Saunders, Gillian Opie, Elaine Kelly, Heather Woods, Emma Marchant, Anne-Marie Turner, Noni Davis, Emma Magrath, Amanda Williamson, Aïda Bairam, Sylvie Bélanger, Annie Fraser, Marc Blayney, Brigitte Lemyre, J. Howard Frank, Alfonso Solimano, Anne Synnes, Ruth E. Grunau, Philippa Hubber-Richard, Marilyn Rogers, Margot Mackay, Julianne Petrie-Thomas, Arsalan Butt, Aleid van Wassenaer, Debbie H. G. M. Nuytemans, Bregje A. Houtzager, L. van Sonderen, Rivka Regev, Netter Itzchack, Shmuel Arnon, Adiba Chalaf, Arne Ohlsson, Karel O’Brien, Anne-Marie Hamilton, May Lee Chan, Koravangattu Sankaran, Pat Proctor, Agneta Golan, Esther Goldsch-Lerman, Graham Reynolds, Barbara Dromgool, Sandra Meskell, Vanessa Parr, Catherine Maher, Margaret Broom, Zsuzsoka Kecskés, Cathy Ringland, Douglas McMillan, Elizabeth Spellen, Reginald S. Sauve, Heather Christianson, Deborah Anseeuw-Deeks, Dianne Creighton, Jennifer Heath, Ruben Alvaro, Aaron Chiu, Ceceile Porter, G. Turner, Diane Moddemann, Naomi Granke, Karen Penner, Jane Bow, Antonius Mulder, Renske Wassenberg, Markus van der Hoeven, Maxine Clarke, Judy Parfitt, Kevin C. H. Parker, Chukwuma Nwaesei, Heather Ryan, Cory D. Saunders, Andreas Schulze, Inga Wermuth, Anne Hilgendorff, Andreas W. Flemmer, Eric Herlenius, Lena Legnevall, Hugo Lagercrantz, Derek Matthew, Wendy Amos, Suresh Tulsiani, Cherrie Tan-Dy, Marilyn L. Turner, Constance Phelan, Eric S. Shinwell, Michael H. Levine, Ada Juster‐Reicher, May Khairy, Patricia Grier, Julie Vachon, Larissa Perepolkin, Keith J. Barrington, Sunil K. Sinha, Win Tin, Susan Fritz, Hervé Walti, Diane Royer, Henry L. Halliday, David Millar, Clifford Mayes, Christopher McCusker, Olivia Marie McLaughlin, Hubert Fahnenstich, Bettina Tillmann, Peter Weber, Unni Wariyar, Nicholas D. Embleton, Ravi Swamy, Hans Ulrich Bucher, Jean‐Claude Fauchère, V. Dietz, C Harikumar, Win Tin, Susan Fritz, Barbara Schmidt, Peter J. Anderson, Elizabeth Asztalos, Keith J. Barrington, Peter G. Davis, Deborah Dewey, Lex W. Doyle, Ruth E. Grunau, Diane Moddemann, Arne Ohlsson, Robin S. Roberts, Alfonso Solimano, Win Tin, Michael Gent, William D. Fraser, Edmund Hey, Max Perlman, Kevin E. Thorpe, Shari Gray, Robin S. Roberts, Carole Chambers, Lorrie Costantini, Wendy Yacura, Erin McGean, Lori Scapinello,

Neonatal and fetal brain pathology

Objective To evaluate bronchopulmonary dysplasia (BPD), serious brain injury, and severe retinopathy of prematurity (ROP) as predictors of poor long-term outcome in very low birth weight infants. Study design We examined the associations between counts of the 3 morbidities and long-term outcomes in 1514 of 1791 (85%) infants with birth weights of 500-1250 g who were enrolled in the Caffeine for Apnea of Prematurity trial from October 1999, to October 2004, had complete morbidity data, and were alive at 36 weeks postmenstrual age (PMA). BPD was defined as use of supplemental oxygen at 36 weeks PMA. Serious brain injury on cranial ultrasound included grade 3 and 4 hemorrhage, cystic periventricular leucomalacia, porencephalic cysts, or ventriculomegaly of any cause. Poor long-term outcome was death after 36 weeks PMA or survival to 5 years with 1 or more of the following disabilities: motor impairment, cognitive impairment, behavior problems, poor general health, deafness, and blindness. Results BPD, serious brain injury, and severe ROP occurred in 43%, 13%, and 6% of the infants, respectively. Each of the 3 morbidities was similarly and independently correlated with poor 5-year outcome. Rates of death or disability (95% CI) in children with none, any 1, any 2, and all 3 morbidities were 11.2% (9.0%-13.7%), 22.9% (19.6%-26.5%), 43.9% (35.5%-52.6%), and 61.5% (40.6%-79.8%), respectively. Conclusions In very low birth weight infants who survive to 36 weeks PMA, a count of BPD, serious brain injury, and severe ROP predicts the risk of a late death or survival with disability at 5 years.