title: Prediction of Late Death or Disability at Age 5 Years Using a Count of 3 Neonatal Morbidities in Very Low Birth Weight Infants.
abstract: OBJECTIVE
  To evaluate bronchopulmonary dysplasia (BPD), serious brain injury, and severe retinopathy of prematurity (ROP) as predictors of poor long-term outcome in very low birth weight infants.
  
  
  METHODS
  We examined the associations between counts of the 3 morbidities and long-term outcomes in 1514 of 1791 (85%) infants with birth weights of 500-1250 g who were enrolled in the Caffeine for Apnea of Prematurity trial from October 1999, to October 2004, had complete morbidity data, and were alive at 36 weeks postmenstrual age (PMA). BPD was defined as use of supplemental oxygen at 36 weeks PMA. Serious brain injury on cranial ultrasound included grade 3 and 4 hemorrhage, cystic periventricular leucomalacia, porencephalic cysts, or ventriculomegaly of any cause. Poor long-term outcome was death after 36 weeks PMA or survival to 5 years with 1 or more of the following disabilities: motor impairment, cognitive impairment, behavior problems, poor general health, deafness, and blindness.
  
  
  RESULTS
  BPD, serious brain injury, and severe ROP occurred in 43%, 13%, and 6% of the infants, respectively. Each of the 3 morbidities was similarly and independently correlated with poor 5-year outcome. Rates of death or disability (95% CI) in children with none, any 1, any 2, and all 3 morbidities were 11.2% (9.0%-13.7%), 22.9% (19.6%-26.5%), 43.9% (35.5%-52.6%), and 61.5% (40.6%-79.8%), respectively.
  
  
  CONCLUSIONS
  In very low birth weight infants who survive to 36 weeks PMA, a count of BPD, serious brain injury, and severe ROP predicts the risk of a late death or survival with disability at 5 years.
authors: Division of Neonatology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. Electronic address: barbara.schmidt@uphs.upenn.edu.
authors: Barbara
authors: B
authors: Schmidt
authors: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors: Robin S
authors: RS
authors: Roberts
authors: Department of Obstetrics and Gynecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors: Peter G
authors: PG
authors: Davis
authors: Department of Obstetrics and Gynecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors: Lex W
authors: LW
authors: Doyle
authors: Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
authors: Elizabeth V
authors: EV
authors: Asztalos
authors: Mercy Hospital, Melbourne, Victoria, Australia.
authors: Gillian
authors: G
authors: Opie
authors: Department of Pediatrics, Laval University, Quebec City, Quebec, Canada.
authors: Aida
authors: A
authors: Bairam
authors: Department of Pediatrics, University of British Columbia, Vancouver, Canada.
authors: Alfonso
authors: A
authors: Solimano
authors: Department of Neonatology, Meir Medical Center, Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Shmuel
authors: S
authors: Arnon
authors: Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
authors: Reginald S
authors: RS
authors: Sauve
mesh_terms: D001766:Blindness / Q000150:complications; D001930:Brain Injuries / Q000150:complications* / Q000401:mortality; D001997:Bronchopulmonary Dysplasia / Q000150:complications* / Q000401:mortality; D002552:Cerebral Ventricles / Q000002:abnormalities; D002653:Child Behavior Disorders / Q000150:complications; D002675:Child, Preschool; D003072:Cognition Disorders / Q000150:complications; D003560:Cysts / Q000150:complications / Q000401:mortality; D003638:Deafness / Q000150:complications; D006233:Persons with Disabilities; D004453:Echoencephalography; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007969:Leukomalacia, Periventricular / Q000150:complications / Q000401:mortality; D008297:Male; D009017:Morbidity; D010100:Oxygen / Q000627:therapeutic use; D011379:Prognosis; D012178:Retinopathy of Prematurity / Q000150:complications* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D010100:Oxygen