Poor Outcomes at Discharge Among Extremely Premature Infants

Kugelman, Amir; Bader, David A.; Lerner‐Geva, Liat; Boyko, Valentina; Levitzki, Orna; Riskin, Arieh; Reichman, Brian

doi:10.1001/archpediatrics.2011.891

Cited by 20 publications

(17 citation statements)

References 39 publications

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“…[53][54][55][56] These factors, in turn, have been shown to be related to a child's neurocognitive impairment. [57][58][59][60] Finally, a common genetic basis may also be involved.…”

Section: Resultsmentioning

confidence: 99%

Late Preterm Birth and Neurocognitive Performance in Late Adulthood: A Birth Cohort Study

et al. 2015

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OBJECTIVES: We studied if late preterm birth (34 weeks 0 days-36 weeks 6 days of gestation) is associated with performance on the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB) in late adulthood and if maximum attained lifetime education moderated these associations.METHODS: Participants were 919 Finnish men and women born between 1934 and 1944, who participated in the Helsinki Birth Cohort Study. They underwent the CERAD-NB at a mean age of 68.1 years. Data regarding gestational age (late preterm versus term) were extracted from hospital birth records, and educational attainment data were gathered from Statistics Finland.RESULTS: After adjustment for major confounders, those born late preterm scored lower on word list recognition (mean difference: -0.33 SD; P = .03) than those born at term. Among those who had attained a basic or upper secondary education, late preterm birth was associated with lower scores on word list recognition, constructional praxis, constructional praxis recall, clock drawing, Mini-Mental State Examination, and memory total and CERAD total 2 compound scores (mean differences: .0.40 SD; P values ,.05), and had a 2.70 times higher risk of mild cognitive impairment (Mini-Mental State Examination score: ,26 points) (P = .02). Among those with tertiary levels of education, late preterm birth was not associated with CERAD-NB scores.CONCLUSIONS: Our findings offer new insight into the lifelong consequences of late preterm birth, and they add late preterm birth as a novel risk factor to the list of neurocognitive impairment in late adulthood. Our findings also suggest that attained lifetime education may mitigate aging-related neurocognitive impairment, especially among those born late preterm. WHAT'S KNOWN ON THIS SUBJECT:More than 70% of all preterm deliveries are late preterm (34-36 weeks of gestation). Existing evidence suggests that compared with those born at term, those born late preterm score lower on neurocognitive tests in childhood and young adulthood. WHAT THIS STUDY ADDS:The effect of late preterm birth on neurocognitive performance persists up to late adulthood, especially among those who have only a basic or upper secondary level of education. Late preterm birth is also associated with a risk of memory impairments.

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“…[53][54][55][56] These factors, in turn, have been shown to be related to a child's neurocognitive impairment. [57][58][59][60] Finally, a common genetic basis may also be involved.…”

Section: Resultsmentioning

confidence: 99%

Late Preterm Birth and Neurocognitive Performance in Late Adulthood: A Birth Cohort Study

et al. 2015

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“…To the best of our knowledge, this is the first Israeli publication addressing issues of death circumstances in the NICU, although statistical national data on deaths of infants born at #26 weeks were recently reported. 12,13 Although neonatal mortality rates have declined in recent decades, the current levels are relatively constant. 14,15 We found that the leading causes of death remained similar throughout the study period and included prematurity and its complications, whereas term neonates died mainly due to congenital anomalies or asphyxia.…”

Section: Discussionmentioning

confidence: 99%

Neonatal End-of-Life Care: A Single-Center NICU Experience in Israel Over a Decade

2013

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WHAT'S KNOWN ON THIS SUBJECT: Neonatal mortality rate and causes of death have been relatively stable in recent years. Decision-making practices preceding death of sick neonates affect the circumstances of death. These practices vary worldwide according to the team approach and local population background.WHAT THIS STUDY ADDS: Although our population is mostly religious, we observed a decline in maximal intensive care along with increasing redirection of care over a decade. Changes in the team approach and increasing level of parental involvement influence type and duration of treatment.abstract OBJECTIVES: To follow changes in the causes of neonatal deaths in the NICU at Hadassah Medical Center, Jerusalem, Israel, over a decade; to examine trends regarding types of end-of-life-care provided (primary nonintervention, maximal intensive, and redirection of intensive care, including limitation of care and withdrawal of life-sustaining treatment); and to assess the parental role in the decision-making process given that the majority of the population is religious. METHODS:All neonates who died between 2000 and 2009 were identified. The causes and circumstances of death were abstracted from the medical records. Trends in end-of-life decisions were compared between 2 time periods:

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“…1,2 Perceived poor outcomes for the smallest and most premature cohort have prompted guidelines for resuscitation with specified limits based on gestational age, 3 though more recent studies have highlighted the influence of other factors on prognosis. 4,5 Guidelines have also attempted to define viability based on birthweight, for example, <500 g 3,6 or <400 g. 7 In a North American survey, most neonatologists would not provide full resuscitation for infants with a birthweight <500 g and a gestation <23 weeks. 8 However, some neonatologists do actively treat infants below these cut-offs.…”

Section: What This Study Addsmentioning

confidence: 99%

“…In recent decades, however, this trend to improving outcome has plateaued . Perceived poor outcomes for the smallest and most premature cohort have prompted guidelines for resuscitation with specified limits based on gestational age, though more recent studies have highlighted the influence of other factors on prognosis . Guidelines have also attempted to define viability based on birthweight, for example, <500 g or <400 g .…”

mentioning

confidence: 99%

Beyond the borderline: Outcomes for inborn infants born at ≤500 grams

Keir

McPhee

Wilkinson

2013

J Paediatrics Child Health

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Poor Outcomes at Discharge Among Extremely Premature Infants

Abstract: To assess risk factors and develop a simple estimate method for poor neonatal outcomes for specific groups of extremely premature infants at birth.

Cited by 20 publications

References 39 publications

Late Preterm Birth and Neurocognitive Performance in Late Adulthood: A Birth Cohort Study

Late Preterm Birth and Neurocognitive Performance in Late Adulthood: A Birth Cohort Study

Neonatal End-of-Life Care: A Single-Center NICU Experience in Israel Over a Decade

Beyond the borderline: Outcomes for inborn infants born at ≤500 grams

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