Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network

Adams‐Chapman, Ira; Heyne, Roy J.; DeMauro, Sara B.; Duncan, Andrea F.; Hintz, Susan R.; Pappas, Athina; Vohr, Betty R.; McDonald, Scott A.; Das, Abhik; Newman, Jamie; Higgins, Rosemary D.

doi:10.1542/peds.2017-3091

Cited by 191 publications

(137 citation statements)

References 36 publications

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“…For the factors that correlated with the TBV/HC, we further investigated the risk for the overestimation of TBV, which was defined by a zTBV measured of 1.5 or smaller than the zTBV predicted . 22 Sensitivity and specificity were used for the evaluation. For the continuous variables (eg, BBW, gestational age at birth, or mCI), the maximum value of the Youden's index on the receiver operating characteristic (ROC) curve 23 was used to define the cutoff value for calculating the sensitivity and specificity.…”

Section: Resultsmentioning

confidence: 99%

“…To investigate the effects of neurodevelopmental risk factors on the HC‐TBV relationship, the correlation between 14 factors, listed in Table , and the TBV/HC ratio were evaluated using Spearman's rank moment correlation coefficient. For the factors that correlated with the TBV/HC, we further investigated the risk for the overestimation of TBV, which was defined by a zTBV measured of 1.5 or smaller than the zTBV predicted . Sensitivity and specificity were used for the evaluation.…”

Section: Methodsmentioning

confidence: 99%

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Clinical Factors That Affect the Relationship between Head Circumference and Brain Volume in Very‐Low‐Birth‐Weight Infants

Kawasaki

Yoshida

Matsui

et al. 2018

Journal of Neuroimaging

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Clinical Factors That Affect the Relationship between Head Circumference and Brain Volume in Very‐Low‐Birth‐Weight Infants

Kawasaki

Yoshida

Matsui

et al. 2018

Journal of Neuroimaging

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“…The EPICURE cohort study from England reported that rates of CP and severe disabilities among surviving children were unchanged between 1995 and 2006 [21]. The US National Institute of Child Health and Human Development Neonatal Research Network reported a decrease in the prevalence of severe CP among extremely preterm infants in the period 2011–2014 [22], and a recent population-based cohort study from Australia documented an increase in non-CP motor impairment among extremely preterm infants from 1991–2005, while rates of CP remained relatively constant [23]. …”

Section: Discussionmentioning

confidence: 99%

Type of Re-Hospitalization and Association with Neonatal Morbidities in Infants of Very Low Birth Weight

et al. 2019

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Background: Preterm infants are at high risk for long-term morbidities and an increased rate of re-hospitalization. Objective: The aim of this study was to evaluate the type of re-hospitalization of very low birth weight (VLBW) infants, from infancy through adolescence, and to assess the association of neonatal morbidities with specific types of re-hospitalization. Study Design: The study cohort comprised 6,385 VLBW infants who were registered with the Maccabi Healthcare Services (MHS) from their birth hospitalization. Data were collected for up to 18 years (median 10.7 years) following neonatal intensive care unit discharge. Hospitalization types were determined from the MHS coding. Neonatal morbidities included necrotizing enterocolitis (NEC), grades 3–4 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP). Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazards model. Results: Overall, 3,956 infants were re-hospitalized at least once and a total of 11,595 hospitalization types were identified. NEC, IVH, PVL, and BPD were associated with significantly higher aHRs for general pediatric (aHR 1.28–1.55), general surgical (aHR 1.18–1.46), and pediatric intensive care unit (aHR 1.57–2.04) hospitalizations. IVH and PVL were associated with significantly higher aHRs for orthopedic (aHR 2.12 and 4.88, respectively) and ophthalmology (1.76 and 4.02, respectively) hospitalizations. IVH was associated with a 14.2-fold higher aHR for neurosurgical admissions, and ROP with a 1.62-fold higher aHR for ophthalmology hospitalizations. Conclusion: Among VLBW infants, specific patterns of re-hospitalization types associated with major neonatal morbidities were identified as particularly high risks for orthopedic and ophthalmology hospitalizations in infants with IVH and PVL, and for intensive care admissions in infants with NEC and BPD.

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“…Extremely preterm birth carries a high risk of death or long-term cerebral impairment. With a current mortality of about 25% and a prevalence of psychomotor impairment in approximately 20% of survivors, more than 10,000 will die each year and a further 10,000 will suffer from cerebral palsy and/or moderate-tosevere cognitive impairment (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Cerebral near-infrared spectroscopy monitoring versus treatment as usual for extremely preterm infants. A protocol for the SafeBoosC phase III randomized clinical trial

Hansen

Pellicer

Gluud

et al. 2019

Preprint

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Background Cerebral oxygenation monitoring may reduce the risk of death and neurologic complications in extremely preterm infants, but no such effects have yet been demonstrated in preterm infants in sufficiently powered randomised clinical trials. The objective of the SafeBoosC-III trial is to investigate the benefits and harms of treatment based on near-infrared spectroscopy (NIRS) monitoring compared with treatment as usual for extremely preterm infants. Methods/Design SafeBoosC III is an investigator-initiated multinational randomized, pragmatic phase III clinical trial. It is open label, but parts will be conducted blinded to intervention. Inclusion criteria consists of infants born below 28 weeks postmenstrual age and parental informed consent (unless the site has is using ‘opt-out’ or deferred consent). Exclusion criteria consists of missing parental informed consent (or if ‘opt-out’ is used, lack of record that clinical staff have explained the trial and the ‘opt-out’ consent process to parents and/or a record in the infant’s clinical file of parents’ decision to opt-out); decision not to provide full life support; and no possibility to initiate cerebral NIRS oximetry within 6 hours after birth. Participants will be randomized 1:1 into either the experimental or control group. Participants in the experimental group will be monitored during the first 72 hours of life with a cerebral NIRS oximeter. Cerebral hypoxia will be treated according to an evidence-based treatment guideline. Participants in the control group will not undergo cerebral oxygenation monitoring and will receive treatment as usual. Each participant will be followed up at 36 weeks postmenstrual age. The primary outcome will be a composite of either death or severe brain injury detected on any of the serial cranial ultrasound scans that are routinely performed in these infants up to 36 weeks postmenstrual age. To detect a 22% relative risk difference between the experimental and control group, we intend to randomize a cohort of 1600 infant. Discussion Treatment guided by cerebral NIRS oximetry has the potential to decrease risk of death or survival with severe brain injury in preterm infants. There is an urgent need to assess the clinical effects of NIRS monitoring among preterm neonates.

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Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network

Abstract: Extremely preterm children are at risk for NDI. Over time, the rate of moderate to severe NDI did not differ, but the rates of severe CP decreased, and mild CP increased.

Cited by 191 publications

References 36 publications

Clinical Factors That Affect the Relationship between Head Circumference and Brain Volume in Very‐Low‐Birth‐Weight Infants

Clinical Factors That Affect the Relationship between Head Circumference and Brain Volume in Very‐Low‐Birth‐Weight Infants

Type of Re-Hospitalization and Association with Neonatal Morbidities in Infants of Very Low Birth Weight

Cerebral near-infrared spectroscopy monitoring versus treatment as usual for extremely preterm infants. A protocol for the SafeBoosC phase III randomized clinical trial

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