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Temporal Trends in Severe Brain Injury and Associated Outcomes in Very Preterm Infants.
Razak, Abdul; Johnston, Emily; Stewart, Alice; Clark, Marissa A T; Stevens, Penelope; Charlton, Margaret; Wong, Flora; McDonald, C; Hunt, Rod W; Miller, Suzanne; Malhotra, Atul.
Afiliación
  • Razak A; Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
  • Johnston E; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
  • Stewart A; The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
  • Clark MAT; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
  • Stevens P; Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
  • Charlton M; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
  • Wong F; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
  • McDonald C; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
  • Hunt RW; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
  • Miller S; Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
  • Malhotra A; Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
Neonatology ; 121(4): 440-449, 2024.
Article en En | MEDLINE | ID: mdl-38471459
ABSTRACT

INTRODUCTION:

Severe brain injury (SBI), including severe intraventricular haemorrhage (sIVH) and cystic periventricular leukomalacia, poses significant challenges for preterm infants, yet recent data and trends are limited.

METHODS:

Analyses were conducted using the Australian and New Zealand Neonatal Network data on preterm infants born <32 weeks' gestation admitted at Monash Children's Hospital, Australia, from January 2014 to April 2021. The occurrence and trends of SBI and sIVH among preterm infants, along with the rates and trends of death and neurodevelopmental impairment (NDI) in SBI infants were assessed.

RESULTS:

Of 1,609 preterm infants, 6.7% had SBI, and 5.6% exhibited sIVH. A total of 37.6% of infants with SBI did not survive to discharge, with 92% of these deaths occurring following redirection of clinical care. Cerebral palsy was diagnosed in 65.2% of SBI survivors, while 86.4% of SBI survivors experienced NDI. No statistically significant differences were observed in the temporal trends of SBI (adjusted OR [95% CI] 1.08 [0.97-1.20]; p = 0.13) or sIVH (adjusted OR [95% CI] 1.09 [0.97-1.21]; p = 0.11). Similarly, there was no statistically significant difference noted in the temporal trend of the composite outcome, which included death or NDI among infants with SBI (adjusted OR [95% CI] 0.90 [0.53-1.53]; p = 0.71).

CONCLUSION:

Neither the rates of SBI nor its associated composite outcome of death or NDI improved over time. A notable proportion of preterm infants with SBI faced redirection of care and subsequent mortality, while most survivors exhibited adverse neurodevelopmental challenges. The development of better therapeutic interventions is imperative to improve outcomes for these vulnerable infants.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Lesiones Encefálicas / Recien Nacido Extremadamente Prematuro Límite: Female / Humans / Infant / Male / Newborn País/Región como asunto: Oceania Idioma: En Revista: Neonatology Asunto de la revista: PERINATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Lesiones Encefálicas / Recien Nacido Extremadamente Prematuro Límite: Female / Humans / Infant / Male / Newborn País/Región como asunto: Oceania Idioma: En Revista: Neonatology Asunto de la revista: PERINATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Suiza