Perinatal Risk Indicators for Long-term Neurological Morbidity Among Preterm Neonates

Teune, Margreet J.; Wassenaer, Aleid G. van; Dommelen, Paula van; Mol, Ben Willem J.

doi:10.1097/01.aoa.0000414069.67193.1b

Cited by 3 publications

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“…Low birth weight survivors have rarely been followed up until school age, which is partially because of time‐consuming and high study cost (Teune et al . ). Studies correlating perinatal brain injury and school performance have varied in their outcomes.…”

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confidence: 97%

Perinatal brain injury, visual motor function and poor school outcome of regional low birth weight survivors at age nine

Zhang

Mahoney

Pinto‐Martin

2012

Journal of Clinical Nursing

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mentioning

confidence: 97%

Perinatal brain injury, visual motor function and poor school outcome of regional low birth weight survivors at age nine

Zhang

Mahoney

Pinto‐Martin

2012

Journal of Clinical Nursing

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“…For all of these outcome measures, the development of prediction models for long‐term child outcomes based on short‐term neonatal outcomes might be an alternative to expensive and often underpowered follow‐up studies 96–98 . To explore the validity of these models, a first step would be to study validity in reports with long‐term follow‐up.…”

Section: Discussionmentioning

confidence: 99%

Long‐term child follow‐up after large obstetric randomised controlled trials for the evaluation of perinatal interventions: a systematic review of the literature

Teune¹,

Wassenaer²,

Malin³

et al. 2012

BJOG

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Background Although the hope is that many perinatal interventions are performed with an ultimate aim to improve the long‐term health and development of the child, long‐term outcome is rarely used as a primary end‐point in perinatal randomised controlled trials (RCTs). Objective To evaluate how often and with which tools long‐term follow‐up is performed after large obstetric RCTs. Search strategy We searched the Cochrane Library for Cochrane reviews published by the Cochrane Pregnancy and Childbirth Group for reviews on interventions that aimed to improve neonatal outcome. Selection criteria Reviews on perinatal interventions that were not performed to improve the condition of the neonate were excluded. We limited our review to RCTs with more than 350 participating women. For each included study, we checked in Web of Science as to whether the researchers had reported on follow‐up in subsequent publications. Data collection and analysis Relevant information was extracted from these RCTs by two reviewers using a predefined data collection sheet. All information was analysed using SPSS 17.0 (SPSS Inc., Chicago, IL, USA). Main results We studied 212 reviews including 1837 RCTs on perinatal interventions, 249 (14%) of which included 350 participants. Only 40 of 249 RCTs (16%) followed the children after discharge from the hospital to evaluate the effect of a specific perinatal intervention. The number of RCTs with long‐term follow‐up remained stable, with 10 of 67 RCTs (15%) reporting follow‐up before 1990, 17 of 115 (15%) between 1990 and 2000, and 13 of 67 (19%) after 2000 (P = 0.68). Conclusions Only a small minority of large perinatal RCTs report the long‐term follow‐up of the child. Future obstetric RCTs should consider performing long‐term follow‐up at the start of the trial.

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“…The risk of unfavorable outcome is higher in those preterm babies suffering from neonatal seizures (NS). In cohorts of preterm newborns, seizures are among the best risk indicators for long-term neurologic morbidity [4]. Seizures on or after day 2 of life predict neurologic outcome at 2 years with an adjusted odds ratio (OR) of 5.8 (1.9-17.8) and at 5 years of age with an adjusted OR of 3.0 (1.1-8.6) 4 .…”

Section: Introductionmentioning

confidence: 99%

“…In cohorts of preterm newborns, seizures are among the best risk indicators for long-term neurologic morbidity [4]. Seizures on or after day 2 of life predict neurologic outcome at 2 years with an adjusted odds ratio (OR) of 5.8 (1.9-17.8) and at 5 years of age with an adjusted OR of 3.0 (1.1-8.6) 4 . In a further study, newborns with NS have an OR of 18 for adverse outcome (95 % CI 3-100), with a 14-times (95 % CI 2-86) OR increase per decreasing week of gestational age [5].…”

Section: Introductionmentioning

confidence: 99%

Neonatal seizures in preterm infants: A systematic review of mortality risk and neurological outcomes from studies in the 2000's

Pisani

Prezioso²,

Spagnoli

2020

Seizure

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Introduction: Neonatal seizures (NS) are associated with increased mortality and risk of cerebral palsy, epilepsy and intellectual disability. We performed a systematic review with the primary objective to delineate the rate of these outcomes following NS in preterm infants from studies published in the 2000's and the secondary objective to identify risk factors. Methods: Inclusion criteria: original articles published between 1/1/2000 and 12/31/2018, written in English, evaluating newborns ≤37 weeks of gestational age and suffering from NS, in which at least one of these was evaluated: epilepsy, cerebral palsy, intellectual disability/developmental delay, normal outcome, death. Results: Twenty-two papers were selected and all were observational, with a retrospective design in 15. Three were population-based and twenty-one have a comparison. It has been found a 22-80 % of mortality, 11.3-38.9 % of epilepsy, 12-84.6 % of cerebral palsy, and 20-42.7 % of intellectual disability/developmental delay rate. An increased risk for all outcomes considered was reported.Risk factors for specific outcomes were provided by a minority of studies. However, inclusion criteria, definition of NS and measured outcomes, follow-up lengths differed considerably between studies. Discussion: Results of the selected studies are only partially comparable or generalizable because of differences in study design. They have a risk for potential biases, although they provide (if analyzed) readily available prognostic factors, easy to apply in clinical practice. Prospective, population-based studies with EEG-defined NS are warranted in order to produce evidence-based guidance for management of preterm newborns with seizures.

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Perinatal Risk Indicators for Long-term Neurological Morbidity Among Preterm Neonates

Cited by 3 publications

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Perinatal brain injury, visual motor function and poor school outcome of regional low birth weight survivors at age nine

Perinatal brain injury, visual motor function and poor school outcome of regional low birth weight survivors at age nine

Long‐term child follow‐up after large obstetric randomised controlled trials for the evaluation of perinatal interventions: a systematic review of the literature

Neonatal seizures in preterm infants: A systematic review of mortality risk and neurological outcomes from studies in the 2000's

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