Article Text

PREDICTION OF CEREBRAL PALSY FROM PERINATAL AND NEONATAL CLINICAL FACTORS AND CEREBRAL ULTRASOUND FINDINGS IN EXTREMELY PRETERM INFANTS
  1. K T Leversen1,
  2. I Elgen1,
  3. R Stoeen2,
  4. A Roennestad3,
  5. J H Skranes4,
  6. P I Kaaresen5,
  7. S Rettedal6,
  8. I E Silberg7,
  9. J Ulriksen8,
  10. I E Engelund9,
  11. K Sommerfelt1,
  12. L M Irgens9,
  13. T Markestad1
  1. 1Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
  2. 2Department of Pediatrics, St Olav University Hospital, Trondheim, Norway
  3. 3Department of Pediatrics, Rikshospitalet University Hospital, Oslo, Norway
  4. 4Department of Pediatrics, Ullevaal University Hospital, Oslo, Norway
  5. 5Department of Pediatrics, University Hospital of Northern Norway, Tromsoe, Norway
  6. 6Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway
  7. 7Department of Pediatrics, Oestfold Hospital, Fredrikstad, Norway
  8. 8Department of Pediatrics, Soerlandet Hospital, Kristiansand, Norway
  9. 9Department of Medical Birth Registry, Norwegian Institute of Public Health, Bergen, Norway

Abstract

Objective 373 children with gestational age <28 weeks or birth weight <1000 g born in Norway in 1999 and 2000 survived to 2 years of age. The aim was to examine predictive values of perinatal and neonatal intensive care unit (NICU) clinical factors and cerebral ultrasound (CUS) on later cerebral palsy (CP).

Methods The risk of CP was estimated in multivariable logistic regression analyses with CP versus no CP as dependent. Preeclampsia, rupture of membranes >6 days, prenatal steroids, chorioamnionitis, vaginal delivery/caesarean section, gender, singletons/multiple births, gestational age, birth weight ratio, illness severity score, postnatal steroids, sepsis, days on assisted ventilation, oxygen requirement at 36 weeks’ gestational age, persistent ductus arteriosus, necrotising enterocolitis and CUS were independent variables.

Results 26 (7%) had CP. The table shows the rates of CP dependent on gestational age and CUS.

Leversen et al

Conclusions In the multivariable model, gestational age (odds ratio (OR) 0.72, 95% CI 0.53 to 0.97) and CUS (periventricular haemorrhage grade 3–4 or multicystic periventricular leucomalacia, OR 18.38, 95% CI 7.31 to 46.23) were the only variables predictive of later CP in extremely premature infants.

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