Background and Aims To describe neurodevelopmental outcomes of ELBW infants in our NICU and to identify characteristics associated with severe disability.
Methods A retrospective cohort study was conducted to collect perinatal factors and neurodevelopmental outcomes at 3 years old among extremely low birth weight (ELBW) infants admitted to the level III NICU at Osaka Medical Center and Research Institute for Maternal and Child Health in Japan from January 1, 2003 to December 31, 2007. Logistic regression was used to identify characteristics associated with cerebral palsy (CP) and mental retardation (MR: corrected developmental quotient < 70).
Results 201 ELBW infants without major congenital anomalies were admitted and 28 (13.9%) of them were discharged by death. Of the remaining 173 survivors, 153 (88.4%) were evaluated. CP and MR occurred in 37 (24.2%) of the assessed infants. Multivariate logistic regression suggested antenatal corticosteroids (45.9% vs 71.6%; adjusted odds ratio, 0.29 [95% CI, 0.14–0.68]) and pulmonary hypertension (PH) treated with inhaled nitric oxide (iNO) (8.1% vs 0.9%; adjusted odds ratio, 13.19 [95% CI, 1.23–138.34]) were the characteristics most highly associated with CP and MR. Of 3 infants, who had suffered from PH treated with iNO at birth and subsequently had CP and MR, 2 infants were delivered after premature rupture of the membranes and 1 was delivered at home accidentally.
Conclusions Antenatal corticosteroids and PH treated with iNO are associated with severe disability of ELBW infants. Further prospective studies involving large samples are required to confirm these results.