المؤلفون: Angelita M. Hensman, Athina Pappas, Krisa P. Van Meurs, Jane E. Brumbaugh, Aasma S. Chaudhary, Breda Munoz, Ivan D. Frantz, Jon E. Tyson, Ronnie Guillet, William E. Truog, David P. Carlton, Myra H. Wyckoff, Claudia Pedroza, Anna Maria Hibbs, Abhik Das, Richard A. Ehrenkranz, Namasivayam Ambalavanan, Elisabeth C. McGowan, Brenda B. Poindexter, Abbot R. Laptook, Rosemary D. Higgins, Pablo J. Sánchez, Seetha Shankaran, Michele C. Walsh, Nehal A. Parikh, Heidi M. Harmon, Roger G. Faix, Ronald N. Goldberg, Gregory M. Sokol, Lina F. Chalak, Edward F. Bell, C. Michael Cotten, Shannon E. G. Hamrick, Kristi L. Watterberg, Uday Devaskar, Valerie Y. Chock

المصدر: JAMA. 318(16)

مصطلحات موضوعية: Male, Randomization, Developmental Disabilities, Encephalopathy, Gestational Age, Hypoxic Ischemic Encephalopathy, Article, law.invention, Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Hypothermia, Induced, Pregnancy, 030225 pediatrics, Medicine, Humans, business.industry, Infant, Newborn, Gestational age, Bayes Theorem, General Medicine, Hypothermia, medicine.disease, Pregnancy Complications, Anesthesia, Hypoxia-Ischemia, Brain, Gestation, Female, medicine.symptom, business, 030217 neurology & neurosurgery

الوصف: Importance Hypothermia initiated at less than 6 hours after birth reduces death or disability for infants with hypoxic-ischemic encephalopathy at 36 weeks’ or later gestation. To our knowledge, hypothermia trials have not been performed in infants presenting after 6 hours. Objective To estimate the probability that hypothermia initiated at 6 to 24 hours after birth reduces the risk of death or disability at 18 months among infants with hypoxic-ischemic encephalopathy. Design, Setting, and Participants A randomized clinical trial was conducted between April 2008 and June 2016 among infants at 36 weeks’ or later gestation with moderate or severe hypoxic-ischemic encephalopathy enrolled at 6 to 24 hours after birth. Twenty-one US Neonatal Research Network centers participated. Bayesian analyses were prespecified given the anticipated limited sample size. Interventions Targeted esophageal temperature was used in 168 infants. Eighty-three hypothermic infants were maintained at 33.5°C (acceptable range, 33°C-34°C) for 96 hours and then rewarmed. Eighty-five noncooled infants were maintained at 37.0°C (acceptable range, 36.5°C-37.3°C). Main Outcomes and Measures The composite of death or disability (moderate or severe) at 18 to 22 months adjusted for level of encephalopathy and age at randomization. Results Hypothermic and noncooled infants were term (mean [SD], 39 [2] and 39 [1] weeks’ gestation, respectively), and 47 of 83 (57%) and 55 of 85 (65%) were male, respectively. Both groups were acidemic at birth, predominantly transferred to the treating center with moderate encephalopathy, and were randomized at a mean (SD) of 16 (5) and 15 (5) hours for hypothermic and noncooled groups, respectively. The primary outcome occurred in 19 of 78 hypothermic infants (24.4%) and 22 of 79 noncooled infants (27.9%) (absolute difference, 3.5%; 95% CI, −1% to 17%). Bayesian analysis using a neutral prior indicated a 76% posterior probability of reduced death or disability with hypothermia relative to the noncooled group (adjusted posterior risk ratio, 0.86; 95% credible interval, 0.58-1.29). The probability that death or disability in cooled infants was at least 1%, 2%, or 3% less than noncooled infants was 71%, 64%, and 56%, respectively. Conclusions and Relevance Among term infants with hypoxic-ischemic encephalopathy, hypothermia initiated at 6 to 24 hours after birth compared with noncooling resulted in a 76% probability of any reduction in death or disability, and a 64% probability of at least 2% less death or disability at 18 to 22 months. Hypothermia initiated at 6 to 24 hours after birth may have benefit but there is uncertainty in its effectiveness. Trial Registration clinicaltrials.gov Identifier:NCT00614744

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::147e4ebd3394f5052fcd620b6d5b2f67
https://pubmed.ncbi.nlm.nih.gov/29672925

المؤلفون: Jane E. Brumbaugh, Shannon E. G. Hamrick, Seetha Shankaran, Athina Pappas, Rebecca Bara, Abhik Das, Michele C. Walsh, Edward G. Shepherd, Richard A. Ehrenkranz, Scott A. McDonald, Amir M. Khan, Heidi M. Harmon, Claudia Pedroza, Carolyn M. Petrie Huitema, Jon E. Tyson, Edward F. Bell, Krisa P. Van Meurs, Lina F. Chalak, Kristi L. Watterberg, Kurt Schibler, John D.E. Barks, Rosemary D. Higgins, C. Michael Cotten, Michelle Hartley-McAndrew, Howard W. Kilbride, Brenda B. Poindexter, Sara B. DeMauro, Namasivayam Ambalavanan, Cathy Grisby, Abbot R. Laptook, Roy J. Heyne, Meena Garg, Uday Devaskar

المصدر: JAMA. 318(1)

مصطلحات موضوعية: Male, Pediatrics, medicine.medical_specialty, Time Factors, Age adjustment, Encephalopathy, Bayley Scales of Infant Development, Hypoxic Ischemic Encephalopathy, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Hypothermia, Induced, 030225 pediatrics, medicine, Humans, Treatment Failure, Original Investigation, business.industry, Absolute risk reduction, Temperature, Infant, Newborn, Infant, Gross Motor Function Classification System, Bayes Theorem, General Medicine, medicine.disease, Death, Neurodevelopmental Disorders, Relative risk, Hypoxia-Ischemia, Brain, Female, Morbidity, business, 030217 neurology & neurosurgery

الوصف: Importance Hypothermia for 72 hours at 33.5°C for neonatal hypoxic-ischemic encephalopathy reduces death or disability, but rates continue to be high. Objective To determine if cooling for 120 hours or to a temperature of 32.0°C reduces death or disability at age 18 months in infants with hypoxic-ischemic encephalopathy. Design, Setting, and Participants Randomized 2 × 2 factorial clinical trial in neonates (≥36 weeks’ gestation) with hypoxic-ischemic encephalopathy at 18 US centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network between October 2010 and January 2016. Interventions A total of 364 neonates were randomly assigned to 4 hypothermia groups: 33.5°C for 72 hours (n = 95), 32.0°C for 72 hours (n = 90), 33.5°C for 120 hours (n = 96), or 32.0°C for 120 hours (n = 83). Main Outcomes and Measures The primary outcome was death or moderate or severe disability at 18 to 22 months of age adjusted for center and level of encephalopathy. Severe disability included any of Bayley Scales of Infant Development III cognitive score less than 70, Gross Motor Function Classification System (GMFCS) level of 3 to 5, or blindness or hearing loss despite amplification. Moderate disability was defined as a cognitive score of 70 to 84 and either GMFCS level 2, active seizures, or hearing with amplification. Results The trial was stopped for safety and futility in November 2013 after 364 of the planned 726 infants were enrolled. Among 347 infants (95%) with primary outcome data (mean age at follow-up, 20.7 [SD, 3.5] months; 42% female), death or disability occurred in 56 of 176 (31.8%) cooled for 72 hours and 54 of 171 (31.6%) cooled for 120 hours (adjusted risk ratio, 0.92 [95% CI, 0.68-1.25]; adjusted absolute risk difference, −1.0% [95% CI, −10.2% to 8.1%]) and in 59 of 185 (31.9%) cooled to 33.5°C and 51 of 162 (31.5%) cooled to 32.0°C (adjusted risk ratio, 0.92 [95% CI, 0.68-1.26]; adjusted absolute risk difference, −3.1% [95% CI, −12.3% to 6.1%]). A significant interaction between longer and deeper cooling was observed ( P = .048), with primary outcome rates of 29.3% at 33.5°C for 72 hours, 34.5% at 32.0°C for 72 hours, 34.4% at 33.5°C for 120 hours, and 28.2% at 32.0°C for 120 hours. Conclusions and Relevance Among term neonates with moderate or severe hypoxic-ischemic encephalopathy, cooling for longer than 72 hours, cooling to lower than 33.5°C, or both did not reduce death or moderate or severe disability at 18 months of age. However, the trial may be underpowered, and an interaction was found between longer and deeper cooling. These results support the current regimen of cooling for 72 hours at 33.5°C. Trial Registration clinicaltrials.gov Identifier:NCT01192776

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a39a5a3d2cf5bfbae082ae81828a5e24
https://pubmed.ncbi.nlm.nih.gov/29748227

المؤلفون: Kristin M. Zaterka-Baxter, Amy K. Hutchinson, Rosemary D. Higgins, Stephen D. Kicklighter, Abbot R. Laptook, C. Michael Cotten, Conra Backstrom Lacy, Carol A. Cole, David K. Wallace, Kristi L. Watterberg, Ann Marie Scorsone, Patricia R. Chess, Namasivayam Ambalavanan, Abhik Das, William Oh, David P. Carlton, Waldemar A. Carlo, Luc P. Brion, Michele C. Walsh, William E Truog, Kartik S. Kumar, Brenda B. Poindexter, Tarah T. Colaizy, Faruk H. Orge, Martin S. Cogen, Edward F. Bell, Matthew M. Laughon, John P Donahue, Michael B. Yang, Gregory M. Sokol, Anna Marie Hibbs, William R. Lucas, Graham E. Quinn, Heidi M. Harmon, Michael W. Gaynon, Krisa P. Van Meurs, Helen A. Mintz-Hittner, Kathleen A. Kennedy, Dale L. Phelps, Tracy L. Nolen, Seetha Shankaran, Denise Hug, Kurt Schibler, Meena Garg, Irena Tsui, Richard J. Olson, Sara B. DeMauro, Timothy W. Winter, Elisabeth C. McGowan, Yu Guang He, Amanda E. Graf, Satyanarayana Lakshminrusimha, Kathryn M. Haider, Don L. Bremer, Mina Chung

المصدر: JAMA. 320:1649

مصطلحات موضوعية: Male, medicine.medical_specialty, Gestational Age, Placebo, Infant, Newborn, Diseases, law.invention, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, law, 030225 pediatrics, Intensive care, Internal medicine, Humans, Medicine, Retinopathy of Prematurity, Treatment Failure, 030212 general & internal medicine, Original Investigation, Cerebral Intraventricular Hemorrhage, Respiratory distress, business.industry, Infant, Newborn, Gestational age, Retinopathy of prematurity, General Medicine, medicine.disease, Infant, Extremely Premature, Relative risk, Necrotizing enterocolitis, Intensive Care, Neonatal, Female, business, Inositol, Follow-Up Studies

الوصف: IMPORTANCE: Previous studies of myo-inositol in preterm infants with respiratory distress found reduced severity of retinopathy of prematurity (ROP) and less frequent ROP, death, and intraventricular hemorrhage. However, no large trials have tested its efficacy or safety. OBJECTIVE: To test the adverse events and efficacy of myo-inositol to reduce type 1 ROP among infants younger than 28 weeks’ gestational age. DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial included 638 infants younger than 28 weeks’ gestational age enrolled from 18 neonatal intensive care centers throughout the United States from April 17, 2014, to September 4, 2015; final date of follow-up was February 12, 2016. The planned enrollment of 1760 participants would permit detection of an absolute reduction in death or type 1 ROP of 7% with 90% power. The trial was terminated early due to a statistically significantly higher mortality rate in the myo-inositol group. INTERVENTIONS: A 40-mg/kg dose of myo-inositol was given every 12 hours (initially intravenously, then enterally when feeding; n = 317) or placebo (n = 321) for up to 10 weeks. MAIN OUTCOMES AND MEASURES: Type 1 ROP or death before determination of ROP outcome was designated as unfavorable. The designated favorable outcome was survival without type 1 ROP. RESULTS: Among 638 infants (mean, 26 weeks’ gestational age; 50% male), 632 (99%) received the trial drug or placebo and 589 (92%) had a study outcome. Death or type 1 ROP occurred more often in the myo-inositol group vs the placebo group (29% vs 21%, respectively; adjusted risk difference, 7% [95% CI, 0%-13%]; adjusted relative risk, 1.41 [95% CI, 1.08-1.83], P = .01). All-cause death before 55 weeks’ postmenstrual age occurred in 18% of the myo-inositol group and in 11% of the placebo group (adjusted risk difference, 6% [95% CI, 0%-11%]; adjusted relative risk, 1.66 [95% CI, 1.14-2.43], P = .007). The most common serious adverse events up to 7 days of receiving the ending dose were necrotizing enterocolitis (6% for myo-inositol vs 4% for placebo), poor perfusion or hypotension (7% vs 4%, respectively), intraventricular hemorrhage (10% vs 9%), systemic infection (16% vs 11%), and respiratory distress (15% vs 13%). CONCLUSIONS AND RELEVANCE: Among premature infants younger than 28 weeks’ gestational age, treatment with myo-inositol for up to 10 weeks did not reduce the risk of type 1 ROP or death vs placebo. These findings do not support the use of myo-inositol among premature infants; however, the early termination of the trial limits definitive conclusions.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::471a4c12ab044e9b390a077c48ca0ade
https://doi.org/10.1001/jama.2018.14996

المؤلفون: Susan Gunn, Stephanie Guilford, Lisa Sulkowski, Shannon E. G. Hamrick, David P. Carlton, Cathy Grisby, Sara B. De Mauro, Scott A. McDonald, Amir M. Khan, Christine A. Gleason, Jeffrey L. Segar, Sandra Grimes, William E. Truog, Lenora Jackson, Conra Backstrom Lacy, Cheri Gauldin, Kimberley A. Fisher, Carmen Garcia, Jacky R. Walker, Nancy S. Newman, Brenda B. Poindexter, Nirupama Laroia, Monica V. Collins, Jonathan M. Klein, Ellen C. Hale, Jeffrey R. Parker, Emilee Little, Tracy L. Nolen, Carol K. Redmond, Sandra Sundquist Beauman, Namasivayam Ambalavanan, Toni Mancini, Richard A. Polin, Aasma S. Chaudhary, Janice Bernhardt, Athina Pappas, Alexis S. Davis, Emma Ramon, Kathleen Weingarden, Laura Sumner, Edward F. Bell, Edward G. Shepherd, Karen J. Johnson, Beena G. Sood, Holly I.M. Wadkins, Robert D. Roghair, Patrick J. Conway, Julie Arldt-McAlister, Mary E. Johnson, Kevin Dysart, Myra H. Wyckoff, Lina F. Chalak, Ann Marie Scorsone, Donia B. Campbell, Rebecca Bara, Howard W. Kilbride, Anne Marie Reynolds, Dennis Wallace, Soraya Abbasi, Satyanarayana Lakshminrusimha, Carl L. Bose, Jon E. Tyson, Kathy Johnson, Ronnie Guillet, Robert T. Burke, Sharon L. Wright, Jeanette O'Donnell Auman, Teresa Chanlaw, Glenda K. Rabe, Suhas G. Kallapur, Ashley Williams, Gail E. Besner, Elisa Vierira, Stephanie Wilson Archer, Waldemar A. Carlo, Greg Muthig, Leslie T. McKinley, Sandra Wuertz, Shirley S. Cosby, Kristin Kirker, Melinda S. Proud, Melinda Caskey, Angelita M. Hensman, Kimberly Hayes-Hart, Karen Martin, Claudia Pedroza, Eugenia K. Pallotto, Carolyn M. Petrie Huitema, Lauritz R. Meyer, Jane E. Brumbaugh, Patricia Luzader, Jamie E. Newman, Georgia E. McDavid, Joanne Finkle, Meena Garg, Carl T. D'Angio, Vipinchandra Bhavsar, Krisa P. Van Meurs, Anne Holmes, Sudarshan R. Jadcherla, Ross Sommers, John D.E. Barks, Rosemary D. Higgins, Traci E Clemons, Leslie Dawn Wilson, Michael G. Sacilowski, Karen A. Wynn, Martin Keszler, Kristi L. Watterberg, Nicole Walker, Christine A. Fortney, Stephanie A. Wiggins, Cary R. Murphy, Marian Willinger, Michael S. Caplan, Betty R. Vohr, Rachel Geller, Ronald N. Goldberg, Margaret M. Crawford, Lucy Smiley, Steven J. Weiner, Dara M. Cucinotta, Barbara Schmidt, Mary E. D'Alton, Tarah T. Colaizy, John M. Dagle, Robin K. Ohls, Gregory M Sokol, Yvonne Loggins, Katrina Burson, Luc P. Brion, Kathleen A. Kennedy, Pablo J. Sánchez, Abbot R. Laptook, Ronald J. Wong, Roy J. Heyne, Anna Maria Hibbs, Haresh Kirpalani, Andrea Halbrook, Carol Kibler, Seetha Shankaran, Patti L. Pierce Tate, Carol H. Hartenberger, Steven J. McElroy, Dan L. Ellsbury, Diana M. Vasil, Teresa L. Gratton, Kurt Schibler, M. Bethany Ball, Michele C. Walsh, Nehal A. Parikh, Maria Batts, Abhik Das, Richard A. Ehrenkranz, Dianne E. Herron, Birju A. Shah, Marian M. Adams, Jenna Gabrio, Jennifer Jennings, Cindy Clark, Barbara J. Stoll, Robert J. Boyle, Matthew M. Laughon, Marie Gantz, Lilia C. De Jesus, Julie B. Lindower, U. Devaskar, Shawna Rodgers, Estelle E. Fischer, Kristin M. Zaterka-Baxter, Mary Christensen, David K. Stevenson, Lijun Chen, Michael G. Ross, Girija Natarajan, Nicholas Guerina, Barbara D. Alexander

المصدر: JAMA, vol 312, iss 24

مصطلحات موضوعية: Male, Neonatal intensive care unit, Time Factors, Developmental Disabilities, Hypothermia, Reproductive health and childbirth, Arrhythmias, Medical and Health Sciences, Hypoxic Ischemic Encephalopathy, law.invention, Randomized controlled trial, law, Hypothermia, Induced, Neonatal, Infant Mortality, Medicine, Duration (project management), Pediatric, Mortality rate, Temperature, Brain, Obstetrics and Gynecology, General Medicine, Intensive Care Units, Anesthesia, Hypoxia-Ischemia, Brain, Female, medicine.symptom, Acidosis, Cardiac, medicine.medical_specialty, Clinical Trials and Supportive Activities, Hemorrhage, Article, Clinical Research, General & Internal Medicine, Intensive Care Units, Neonatal, Hypoxia-Ischemia, Humans, Survival analysis, business.industry, Induced, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Infant, Newborn, Infant, Arrhythmias, Cardiac, Thrombosis, Perinatal Period - Conditions Originating in Perinatal Period, Newborn, Survival Analysis, Surgery, Clinical trial, Relative risk, business

الوصف: Importance Hypothermia at 33.5°C for 72 hours for neonatal hypoxic ischemic encephalopathy reduces death or disability to 44% to 55%; longer cooling and deeper cooling are neuroprotective in animal models. Objective To determine if longer duration cooling (120 hours), deeper cooling (32.0°C), or both are superior to cooling at 33.5°C for 72 hours in neonates who are full-term with moderate or severe hypoxic ischemic encephalopathy. Design, Setting, and Participants A randomized, 2 × 2 factorial design clinical trial performed in 18 US centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network between October 2010 and November 2013. Interventions Neonates were assigned to 4 hypothermia groups; 33.5°C for 72 hours, 32.0°C for 72 hours, 33.5°C for 120 hours, and 32.0°C for 120 hours. Main Outcomes and Measures The primary outcome of death or disability at 18 to 22 months is ongoing. The independent data and safety monitoring committee paused the trial to evaluate safety (cardiac arrhythmia, persistent acidosis, major vessel thrombosis and bleeding, and death in the neonatal intensive care unit [NICU]) after the first 50 neonates were enrolled, then after every subsequent 25 neonates. The trial was closed for emerging safety profile and futility analysis after the eighth review with 364 neonates enrolled (of 726 planned). This report focuses on safety and NICU deaths by marginal comparisons of 72 hours’ vs 120 hours’ duration and 33.5°C depth vs 32.0°C depth (predefined secondary outcomes). Results The NICU death rates were 7 of 95 neonates (7%) for the 33.5°C for 72 hours group, 13 of 90 neonates (14%) for the 32.0°C for 72 hours group, 15 of 96 neonates (16%) for the 33.5°C for 120 hours group, and 14 of 83 neonates (17%) for the 32.0°C for 120 hours group. The adjusted risk ratio (RR) for NICU deaths for the 120 hours group vs 72 hours group was 1.37 (95% CI, 0.92-2.04) and for the 32.0°C group vs 33.5°C group was 1.24 (95% CI, 0.69-2.25). Safety outcomes were similar between the 120 hours group vs 72 hours group and the 32.0°C group vs 33.5°C group, except major bleeding occurred among 1% in the 120 hours group vs 3% in the 72 hours group (RR, 0.25 [95% CI, 0.07-0.91]). Futility analysis determined that the probability of detecting a statistically significant benefit for longer cooling, deeper cooling, or both for NICU death was less than 2%. Conclusions and Relevance Among neonates who were full-term with moderate or severe hypoxic ischemic encephalopathy, longer cooling, deeper cooling, or both compared with hypothermia at 33.5°C for 72 hours did not reduce NICU death. These results have implications for patient care and design of future trials. Trial Registration clinicaltrials.gov Identifier:NCT01192776

وصف الملف: application/pdf

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bfc1161ccd31cb7fbe9f4fa2939ba5e6
https://pubmed.ncbi.nlm.nih.gov/28295535

المؤلفون: Barbara J. Stoll, Ira Adams-Chapman, Avroy A. Fanaroff, Nellie I. Hansen, Susan R. Hintz, Rosemary D. Higgins, Betty R. Vohr

المصدر: JAMA. 292(19)

مصطلحات موضوعية: Male, Pediatrics, medicine.medical_specialty, Birth weight, Developmental Disabilities, Vision Disorders, Growth, Infant, Premature, Diseases, Infections, Bayley Scales of Infant Development, Cohort Studies, Enterocolitis, Necrotizing, Intensive care, Sepsis, medicine, Humans, Infant, Very Low Birth Weight, Meningitis, Hearing Loss, business.industry, Cerebral Palsy, Infant, Newborn, Gestational age, Infant, General Medicine, medicine.disease, Neonatal infection, Low birth weight, Necrotizing enterocolitis, Female, medicine.symptom, business, Cohort study

الوصف: ContextNeonatal infections are frequent complications of extremely low-birth-weight (ELBW) infants receiving intensive care.ObjectiveTo determine if neonatal infections in ELBW infants are associated with increased risks of adverse neurodevelopmental and growth sequelae in early childhood.Design, Setting, and ParticipantsInfants weighing 401 to 1000 g at birth (born in 1993-2001) were enrolled in a prospectively collected very low-birth-weight registry at academic medical centers participating in the National Institute of Child Health and Human Development Neonatal Research Network. Neurodevelopmental and growth outcomes were assessed at a comprehensive follow-up visit at 18 to 22 months of corrected gestational age and compared by infection group. Eighty percent of survivors completed the follow-up visit and 6093 infants were studied. Registry data were used to classify infants by type of infection: uninfected (n = 2161), clinical infection alone (n = 1538), sepsis (n = 1922), sepsis and necrotizing enterocolitis (n = 279), or meningitis with or without sepsis (n = 193).Main Outcome MeasuresCognitive and neuromotor development, neurologic status, vision and hearing, and growth (weight, length, and head circumference) were assessed at follow-up.ResultsThe majority of ELBW survivors (65%) had at least 1 infection during their hospitalization after birth. Compared with uninfected infants, those in each of the 4 infection groups were significantly more likely to have adverse neurodevelopmental outcomes at follow-up, including cerebral palsy (range of significant odds ratios [ORs], 1.4-1.7), low Bayley Scales of Infant Development II scores on the mental development index (ORs, 1.3-1.6) and psychomotor development index (ORs, 1.5-2.4), and vision impairment (ORs, 1.3-2.2). Infection in the neonatal period was also associated with impaired head growth, a known predictor of poor neurodevelopmental outcome.ConclusionsThis large cohort study suggests that neonatal infections among ELBW infants are associated with poor neurodevelopmental and growth outcomes in early childhood. Additional studies are needed to elucidate the pathogenesis of brain injury in infants with infection so that novel interventions to improve these outcomes can be explored.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a4c107b5b09ca4d26bf8b620be0fff37
https://pubmed.ncbi.nlm.nih.gov/15728163