OBJECTIVE: The aim of this study was to investigate to what extend perinatal factors contribute to the neurodevelopmental outcome in a group neonates born after spontaneous preterm labour with or without prolonged rupture of the membranes (PROM). METHODS: In a cohort of neonates born after the spontaneous onset of labour with or without PROM before 34 weeks of gestation a stepwise forward logistic regression was performed to analyse the influence of antenatal and postnatal variables on adverse outcome. Adverse neurodevelopmental outcome was defined as a Griffith's developmental score <85, cerebral palsy, a major disability or perinatal death associated with severe cerebral damage. RESULTS: The study group consisted of 185 neonates. Seven neonates died with severe cerebral damage. After a forward logistic regression analysis three factors appeared to have an independent influence: gestational age protected against an adverse outcome (odds ratio (OR) per day increase 0.95, 95\% confidence interval (CI) 0.90-0.97) while abnormal cranial ultrasound (intraventricular haemorrhage and periventricular leucomalacia) (OR 6.33, 95\% CI 2.16-18.52) and the need for a second course of antibiotics (OR 1.85, 95\% CI 1.02-3.33) increased the risk for adverse outcome. Comparing the group with a normal neurodevelopmental outcome with those with cerebral palsy, cranial ultrasound abnormalities were independently associated with cerebral palsy (OR 48.75, 95\% CI 11.78-201.76). CONCLUSION: The most important way of preventing neurological damage in infants is to increase gestational age at birth and to avoid the development of intraventricular haemorrhage and periventricular leucomalacia.
%0 Journal Article
%1 Vermeulen2001
%A Vermeulen, G. M.
%A Bruinse, H. W.
%A de Vries, L. S.
%D 2001
%J Eur J Obstet Gynecol Reprod Biol
%K Anti-Bacterial Agents; Brain Diseases; Cerebral Hemorrhage; Palsy; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infant Mortality; Infant, Newborn; Premature; Infection; Leukomalacia, Periventricular; Logistic Models; Nervous System; Obstetric Labor, Odds Ratio; Pregnancy; Risk Factors
%N 2
%P 207--212
%T Perinatal risk factors for adverse neurodevelopmental outcome after spontaneous preterm birth.
%V 99
%X OBJECTIVE: The aim of this study was to investigate to what extend perinatal factors contribute to the neurodevelopmental outcome in a group neonates born after spontaneous preterm labour with or without prolonged rupture of the membranes (PROM). METHODS: In a cohort of neonates born after the spontaneous onset of labour with or without PROM before 34 weeks of gestation a stepwise forward logistic regression was performed to analyse the influence of antenatal and postnatal variables on adverse outcome. Adverse neurodevelopmental outcome was defined as a Griffith's developmental score <85, cerebral palsy, a major disability or perinatal death associated with severe cerebral damage. RESULTS: The study group consisted of 185 neonates. Seven neonates died with severe cerebral damage. After a forward logistic regression analysis three factors appeared to have an independent influence: gestational age protected against an adverse outcome (odds ratio (OR) per day increase 0.95, 95\% confidence interval (CI) 0.90-0.97) while abnormal cranial ultrasound (intraventricular haemorrhage and periventricular leucomalacia) (OR 6.33, 95\% CI 2.16-18.52) and the need for a second course of antibiotics (OR 1.85, 95\% CI 1.02-3.33) increased the risk for adverse outcome. Comparing the group with a normal neurodevelopmental outcome with those with cerebral palsy, cranial ultrasound abnormalities were independently associated with cerebral palsy (OR 48.75, 95\% CI 11.78-201.76). CONCLUSION: The most important way of preventing neurological damage in infants is to increase gestational age at birth and to avoid the development of intraventricular haemorrhage and periventricular leucomalacia.
@article{Vermeulen2001,
abstract = {OBJECTIVE: The aim of this study was to investigate to what extend perinatal factors contribute to the neurodevelopmental outcome in a group neonates born after spontaneous preterm labour with or without prolonged rupture of the membranes (PROM). METHODS: In a cohort of neonates born after the spontaneous onset of labour with or without PROM before 34 weeks of gestation a stepwise forward logistic regression was performed to analyse the influence of antenatal and postnatal variables on adverse outcome. Adverse neurodevelopmental outcome was defined as a Griffith's developmental score <85, cerebral palsy, a major disability or perinatal death associated with severe cerebral damage. RESULTS: The study group consisted of 185 neonates. Seven neonates died with severe cerebral damage. After a forward logistic regression analysis three factors appeared to have an independent influence: gestational age protected against an adverse outcome (odds ratio (OR) per day increase 0.95, 95\% confidence interval (CI) 0.90-0.97) while abnormal cranial ultrasound (intraventricular haemorrhage and periventricular leucomalacia) (OR 6.33, 95\% CI 2.16-18.52) and the need for a second course of antibiotics (OR 1.85, 95\% CI 1.02-3.33) increased the risk for adverse outcome. Comparing the group with a normal neurodevelopmental outcome with those with cerebral palsy, cranial ultrasound abnormalities were independently associated with cerebral palsy (OR 48.75, 95\% CI 11.78-201.76). CONCLUSION: The most important way of preventing neurological damage in infants is to increase gestational age at birth and to avoid the development of intraventricular haemorrhage and periventricular leucomalacia.},
added-at = {2014-07-19T21:50:59.000+0200},
author = {Vermeulen, G. M. and Bruinse, H. W. and de Vries, L. S.},
biburl = {https://www.bibsonomy.org/bibtex/2b79349d0aa177c10918dc0311118b5b2/ar0berts},
groups = {public},
interhash = {61ec1b7d370649fb0f4372738cef732c},
intrahash = {b79349d0aa177c10918dc0311118b5b2},
journal = {Eur J Obstet Gynecol Reprod Biol},
keywords = {Anti-Bacterial Agents; Brain Diseases; Cerebral Hemorrhage; Palsy; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infant Mortality; Infant, Newborn; Premature; Infection; Leukomalacia, Periventricular; Logistic Models; Nervous System; Obstetric Labor, Odds Ratio; Pregnancy; Risk Factors},
month = Dec,
number = 2,
pages = {207--212},
pii = {S0301211501003839},
pmid = {11788173},
timestamp = {2014-07-19T21:50:59.000+0200},
title = {Perinatal risk factors for adverse neurodevelopmental outcome after spontaneous preterm birth.},
username = {ar0berts},
volume = 99,
year = 2001
}