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Schmidt B, Roberts RS, Davis PG, Doyle LW, Asztalos EV, Opie G, Bairam A, Solimano A, Arnon S, Sauve RS, Cairnie J, Dix J, Adams BA, Warriner E, Marie Kim MH, Anderson P, Davis P, Doyle L, Argus B, Callanan C, Davis N, Duff J, McDonald M, Asztalos E, Hohn D, Lacy M, Haslam R, Barnett C, Goodchild L, Lontis RM, Fraser S, Keng J, Saunders K, Opie G, Kelly E, Woods H, Marchant E, Turner AM, Davis N, Magrath E, Williamson A, Bairam A, Bélanger S, Fraser A, Blayney M, Lemyre B, Frank J, Solimano A, Synnes A, Grunau RE, Hubber-Richard P, Rogers M, Mackay M, Petrie-Thomas J, Butt A, van Wassenaer A, Nuytemans D, Houtzager B, van Sonderen L, Regev R, Itzchack N, Arnon S, Chalaf A, Ohlsson A, O'Brien K, Hamilton AM, Chan ML, Sankaran K, Proctor P, Golan A, Goldsch-Lerman E, Reynolds G, Dromgool B, Meskell S, Parr V, Maher C, Broom M, Kecskes Z, Ringland C, McMillan D, Spellen E, Sauve RS, Christianson H, Anseeuw-Deeks D, Creighton D, Heath J, Alvaro R, Chiu A, Porter C, Turner G, Moddemann D, Granke N, Penner K, Bow J, Mulder A, Wassenberg R, van der Hoeven M, Clarke M, Parfitt J, Parker K, Nwaesei C, Ryan H, Saunders C, Schulze A, Wermuth I, Hilgendorff A, Flemmer AW, Herlenius E, Legnevall L, Lagercrantz H, Matthew D, Amos W, Tulsiani S, Tan-Dy C, Turner M, Phelan C, Shinwell ES, Levine M, Juster-Reicher A, Khairy M, Grier P, Vachon J, Perepolkin L, Barrington KJ, Sinha SK, Tin W, Fritz S, Walti H, Royer D, Halliday H, Millar D, Mayes C, McCusker C, McLaughlin O, Fahnenstich H, Tillmann B, Weber P, Wariyar U, Embleton N, Swamy R, Bucher HU, Fauchere JC, Dietz V, Harikumar C, Tin W, Fritz S, Schmidt B, Anderson PJ, Asztalos EV, Barrington KJ, Davis PG, Dewey D, Doyle LW, Grunau RE, Moddemann D, Ohlsson A, Roberts RS, Solimano A, Tin W, Gent M, Fraser W, Hey E, Perlman M, Thorpe K, Gray S, Roberts RS, Chambers C, Costantini L, Yacura W, McGean E, Scapinello L. Prediction of Late Death or Disability at Age 5 Years Using a Count of 3 Neonatal Morbidities in Very Low Birth Weight Infants. J Pediatr 2015; 167:982-6.e2. [PMID: 26318030 DOI: 10.1016/j.jpeds.2015.07.067] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 07/08/2015] [Accepted: 07/30/2015] [Indexed: 12/30/2022]
Abstract
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.
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Affiliation(s)
- Barbara Schmidt
- Division of Neonatology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
| | - Robin S Roberts
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Peter G Davis
- Department of Obstetrics and Gynecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Lex W Doyle
- Department of Obstetrics and Gynecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | | | | | - Aida Bairam
- Department of Pediatrics, Laval University, Quebec City, Quebec, Canada
| | - Alfonso Solimano
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Shmuel Arnon
- Department of Neonatology, Meir Medical Center, Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Reginald S Sauve
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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