Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages.
OBJECTIVE
Assessment of risk predictors for adverse neurodevelopmental outcome at 1 year of age in preterm infants with a gestational age <30 weeks (Group I) and 30-32 weeks (Group II).


METHODS
Between January 2003 and December 2006, we prospectively enrolled 310 live-born infants between 23 and 32 weeks of gestation. The association between candidate risk factors and delayed motor or mental development (Bayley Scales of infant development II; psychomotor or mental developmental index <85) was analysed by means of logistic regression analysis.


RESULTS
Two hundred and fifty infants were eligible for follow-up, and 205 (82.0%) completed the follow-up visit. Intracerebral haemorrhage, small for gestational age and late-onset sepsis were associated with an increased risk for delayed development in Group I (p < 0.05, each). Premature rupture of membranes was a risk condition relevant to Group II. Antenatal steroids were associated with a decreased risk of neurodevelopmental delay in both groups.


CONCLUSIONS
This study identified distinct risk factors for adverse outcome in preterm infants of lower (<30 weeks) and higher (30-32 weeks) gestational age. In the lower gestational age group, neonatal risk predictors are most important. Antenatal steroids appear to decrease the risk for adverse outcome in both age groups.
Kiechl-Kohlendorfer
U
U
Department of Paediatrics, Division of Neonatology, Neuropaediatrics and Metabolic Disorders, Innsbruck Medical University, Innsbruck, Austria. ursula.kohlendorfer@i-med.ac.at
Ralser
E
E
Pupp Peglow
U
U
Reiter
G
G
Trawöger
R
R
D001317:Austria / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors