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Risk Factors for Adverse Outcome in Preterm Infants With Periventricular Hemorrhagic Infarction
Our objective was to identify risk factors that were associated with mortality and adverse neurologic outcome at 18 months of age in preterm infants with periventricular hemorrhagic infarction. This was a retrospective cohort study of all preterm infants who were
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| Published in: | Pediatrics (Evanston) 2008-07, Vol.122 (1), p.e46-e52 |
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| creator | Roze, Elise Kerstjens, Jorien M Maathuis, Carel G.B ter Horst, Hendrik J Bos, Arend F |
| description | Our objective was to identify risk factors that were associated with mortality and adverse neurologic outcome at 18 months of age in preterm infants with periventricular hemorrhagic infarction.
This was a retrospective cohort study of all preterm infants who were |
| doi_str_mv | 10.1542/peds.2007-3305 |
| format | article |
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This was a retrospective cohort study of all preterm infants who were <37 weeks' gestation, had periventricular hemorrhagic infarction, and were admitted between 1995 and 2006. Ultrasound scans were reviewed for grading of germinal matrix hemorrhage, localization and extension of the infarction, and other abnormalities. Several clinical factors were scored. Outcome measures were mortality, cerebral palsy, and Gross Motor Function Classification System level. Odds ratios were calculated by univariate and multivariate logistic regression analyses.
Of 54 infants, 16 (30%) died. Twenty-five (66%) of 38 survivors developed cerebral palsy: 21 mild (Gross Motor Function Classification System levels 1 and 2) and 4 moderate to severe (levels 3 and 4). Several perinatal and neonatal risk factors were associated with mortality. After multivariate logistic regression, only use of inotropic drugs and maternal intrauterine infection were predictors of mortality. In survivors, only the most extended form of periventricular hemorrhagic infarction was associated with the development of cerebral palsy but not with severity of cerebral palsy. Cystic periventricular leukomalacia and concurrent grade 3 germinal matrix hemorrhage were associated with more severe cerebral palsy.
In preterm infants with periventricular hemorrhagic infarction, mortality occurred despite optimal treatment and was associated with circulatory failure and maternal intrauterine infection. In survivors, motor development was abnormal in 66%, but functional abilities were good in the majority. Extension and localization of the periventricular hemorrhagic infarction were not related to functional outcome.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2007-3305</identifier><identifier>PMID: 18541618</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>United States: Am Acad Pediatrics</publisher><subject>Babies ; Cerebral Hemorrhage - complications ; Cerebral Hemorrhage - mortality ; Cerebral Infarction - complications ; Cerebral Infarction - mortality ; Cerebral Palsy - epidemiology ; Cerebral Palsy - etiology ; Clinical medicine ; Heart attacks ; Hemorrhage ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases - mortality ; Logistic Models ; Odds Ratio ; Pediatrics ; Retrospective Studies ; Risk Factors ; Survival Analysis</subject><ispartof>Pediatrics (Evanston), 2008-07, Vol.122 (1), p.e46-e52</ispartof><rights>Copyright American Academy of Pediatrics Jul 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-e277d937119ce3dcb5e94f466d3d183c25ac73817c693e5c9b9223530a0d8b6c3</citedby><cites>FETCH-LOGICAL-c390t-e277d937119ce3dcb5e94f466d3d183c25ac73817c693e5c9b9223530a0d8b6c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18541618$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roze, Elise</creatorcontrib><creatorcontrib>Kerstjens, Jorien M</creatorcontrib><creatorcontrib>Maathuis, Carel G.B</creatorcontrib><creatorcontrib>ter Horst, Hendrik J</creatorcontrib><creatorcontrib>Bos, Arend F</creatorcontrib><title>Risk Factors for Adverse Outcome in Preterm Infants With Periventricular Hemorrhagic Infarction</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Our objective was to identify risk factors that were associated with mortality and adverse neurologic outcome at 18 months of age in preterm infants with periventricular hemorrhagic infarction.
This was a retrospective cohort study of all preterm infants who were <37 weeks' gestation, had periventricular hemorrhagic infarction, and were admitted between 1995 and 2006. Ultrasound scans were reviewed for grading of germinal matrix hemorrhage, localization and extension of the infarction, and other abnormalities. Several clinical factors were scored. Outcome measures were mortality, cerebral palsy, and Gross Motor Function Classification System level. Odds ratios were calculated by univariate and multivariate logistic regression analyses.
Of 54 infants, 16 (30%) died. Twenty-five (66%) of 38 survivors developed cerebral palsy: 21 mild (Gross Motor Function Classification System levels 1 and 2) and 4 moderate to severe (levels 3 and 4). Several perinatal and neonatal risk factors were associated with mortality. After multivariate logistic regression, only use of inotropic drugs and maternal intrauterine infection were predictors of mortality. In survivors, only the most extended form of periventricular hemorrhagic infarction was associated with the development of cerebral palsy but not with severity of cerebral palsy. Cystic periventricular leukomalacia and concurrent grade 3 germinal matrix hemorrhage were associated with more severe cerebral palsy.
In preterm infants with periventricular hemorrhagic infarction, mortality occurred despite optimal treatment and was associated with circulatory failure and maternal intrauterine infection. In survivors, motor development was abnormal in 66%, but functional abilities were good in the majority. Extension and localization of the periventricular hemorrhagic infarction were not related to functional outcome.</description><subject>Babies</subject><subject>Cerebral Hemorrhage - complications</subject><subject>Cerebral Hemorrhage - mortality</subject><subject>Cerebral Infarction - complications</subject><subject>Cerebral Infarction - mortality</subject><subject>Cerebral Palsy - epidemiology</subject><subject>Cerebral Palsy - etiology</subject><subject>Clinical medicine</subject><subject>Heart attacks</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Premature, Diseases - mortality</subject><subject>Logistic Models</subject><subject>Odds Ratio</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNqFkT1rHDEQQEWIic9O2pRBpEi3l9HXSiqN8RcYbExCSqHTzvrk3K4uktbB_9638YFDmlSa4s2D0SPkI4MlU5J_3WJXlhxAN0KAekMWDKxpJNfqLVkACNZIAHVIjkp5AACpNH9HDplRkrXMLIi7i-UnPfehplxonzI96R4xF6Q3Uw1pQBpHepuxYh7o1dj7sRb6I9Y1vcUcH3GsOYZp4zO9xCHlvPb3MfwBc6gxje_JQe83BT_s32Py_fzs2-llc31zcXV6ct0EYaE2yLXurNCM2YCiCyuFVvaybTvRMSMCVz5oYZgOrRWogl1ZzoUS4KEzqzaIY_LlxbvN6deEpbohloCbjR8xTcW1lhvNrPovyEELkFbswM__gA9pyuPuCMe5EUYK4Dto-QKFnErJ2LttjoPPT46BmwO5OZCbA7k50G7h0946rQbsXvF9kVfjOt6vf8eMsyH6-ZvLXyPj3DGHshXPO6Cccg</recordid><startdate>20080701</startdate><enddate>20080701</enddate><creator>Roze, Elise</creator><creator>Kerstjens, Jorien M</creator><creator>Maathuis, Carel G.B</creator><creator>ter Horst, Hendrik J</creator><creator>Bos, Arend F</creator><general>Am Acad Pediatrics</general><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7TK</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20080701</creationdate><title>Risk Factors for Adverse Outcome in Preterm Infants With Periventricular Hemorrhagic Infarction</title><author>Roze, Elise ; Kerstjens, Jorien M ; Maathuis, Carel G.B ; ter Horst, Hendrik J ; Bos, Arend F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-e277d937119ce3dcb5e94f466d3d183c25ac73817c693e5c9b9223530a0d8b6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Babies</topic><topic>Cerebral Hemorrhage - complications</topic><topic>Cerebral Hemorrhage - mortality</topic><topic>Cerebral Infarction - complications</topic><topic>Cerebral Infarction - mortality</topic><topic>Cerebral Palsy - epidemiology</topic><topic>Cerebral Palsy - etiology</topic><topic>Clinical medicine</topic><topic>Heart attacks</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases - mortality</topic><topic>Logistic Models</topic><topic>Odds Ratio</topic><topic>Pediatrics</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roze, Elise</creatorcontrib><creatorcontrib>Kerstjens, Jorien M</creatorcontrib><creatorcontrib>Maathuis, Carel G.B</creatorcontrib><creatorcontrib>ter Horst, Hendrik J</creatorcontrib><creatorcontrib>Bos, Arend F</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Neurosciences Abstracts</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roze, Elise</au><au>Kerstjens, Jorien M</au><au>Maathuis, Carel G.B</au><au>ter Horst, Hendrik J</au><au>Bos, Arend F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Adverse Outcome in Preterm Infants With Periventricular Hemorrhagic Infarction</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2008-07-01</date><risdate>2008</risdate><volume>122</volume><issue>1</issue><spage>e46</spage><epage>e52</epage><pages>e46-e52</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>Our objective was to identify risk factors that were associated with mortality and adverse neurologic outcome at 18 months of age in preterm infants with periventricular hemorrhagic infarction.
This was a retrospective cohort study of all preterm infants who were <37 weeks' gestation, had periventricular hemorrhagic infarction, and were admitted between 1995 and 2006. Ultrasound scans were reviewed for grading of germinal matrix hemorrhage, localization and extension of the infarction, and other abnormalities. Several clinical factors were scored. Outcome measures were mortality, cerebral palsy, and Gross Motor Function Classification System level. Odds ratios were calculated by univariate and multivariate logistic regression analyses.
Of 54 infants, 16 (30%) died. Twenty-five (66%) of 38 survivors developed cerebral palsy: 21 mild (Gross Motor Function Classification System levels 1 and 2) and 4 moderate to severe (levels 3 and 4). Several perinatal and neonatal risk factors were associated with mortality. After multivariate logistic regression, only use of inotropic drugs and maternal intrauterine infection were predictors of mortality. In survivors, only the most extended form of periventricular hemorrhagic infarction was associated with the development of cerebral palsy but not with severity of cerebral palsy. Cystic periventricular leukomalacia and concurrent grade 3 germinal matrix hemorrhage were associated with more severe cerebral palsy.
In preterm infants with periventricular hemorrhagic infarction, mortality occurred despite optimal treatment and was associated with circulatory failure and maternal intrauterine infection. In survivors, motor development was abnormal in 66%, but functional abilities were good in the majority. Extension and localization of the periventricular hemorrhagic infarction were not related to functional outcome.</abstract><cop>United States</cop><pub>Am Acad Pediatrics</pub><pmid>18541618</pmid><doi>10.1542/peds.2007-3305</doi></addata></record> |
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| subjects | Babies Cerebral Hemorrhage - complications Cerebral Hemorrhage - mortality Cerebral Infarction - complications Cerebral Infarction - mortality Cerebral Palsy - epidemiology Cerebral Palsy - etiology Clinical medicine Heart attacks Hemorrhage Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases - mortality Logistic Models Odds Ratio Pediatrics Retrospective Studies Risk Factors Survival Analysis |
| title | Risk Factors for Adverse Outcome in Preterm Infants With Periventricular Hemorrhagic Infarction |
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