Outcome to 8 years of infants less than 1000 g birthweight: relationship with neonatal ventilator and oxygen therapy.
The study involved a cohort of 59 consecutive survivors with birthweights less than 1000 g, born between 1977 and 1980, to 8 years of age. The aim of the report was to determine if those survivors who had received more oxygen and ventilator therapy differed in their outcome compared with those who had received less oxygen and ventilation. Children were graded into four groups, characterized by decreasing durations of oxygen and ventilation. Children who had received less oxygen and ventilation were more likely to be below the third percentile for weight at 2, 5 and 8 years but the trends were significant only at 2 and 5 years (P = 0.006, P = 0.013 and P = 0.19 respectively). The rate of cerebral palsy was 8% at 8 years; the only children with severe or moderate disabilities from their cerebral palsy were in the lowest oxygen and ventilation group (n = 4, P less than 0.02). The frequency of hospital re-admission and the duration of re-hospitalization did not vary significantly between the four groups at any age. The rates of recurrent wheezing episodes or asthma did not vary significantly between the groups. Although the cohort as a whole had some impairment of lung function compared with healthy full-term controls, there was no significant difference between the four groups. Contrary to expectations, our findings suggest lower rates of poor growth and adverse neurological outcomes with increasing durations of oxygen and ventilation in the newborn period.
Doyle
L W
LW
Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia.
Kitchen
W H
WH
Ford
G W
GW
Rickards
A L
AL
Kelly
E A
EA
Callanan
C
C
Raven
J
J
Olinsky
A
A
D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000209:etiology; D002547:Cerebral Palsy / Q000209:etiology; D002648:Child; D002657:Child Development; D005500:Follow-Up Studies; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000628:therapy*; D007385:Intermittent Positive-Pressure Ventilation / Q000009:adverse effects; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects; D010359:Patient Readmission / Q000706:statistics & numerical data; D012140:Respiratory Tract Diseases / Q000453:epidemiology