Neurodevelopmental Outcome of Extremely Low Birth Weight Infants from the Vermont Oxford Network: 1998-2003
Neurodevelopmental Outcome of Extremely Low Birth Weight Infants from the Vermont Oxford Network: 1998-2003
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DOI：
10.1159/000260136
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发表时间：
2010-01-01
期刊：
影响因子：
2.5
通讯作者：
Soll, Roger F.
中科院分区：
文献类型：
--
作者：
Mercier, Charles E.;Dunn, Michael S.;Soll, Roger F.
背景：医生和父母在为极低出生体重儿（ELBW）做出护理决定时面临着重大的不确定性。许多已发表的死亡和发育结果的估计来自资金充足的大学项目，可能无法反映各种环境下婴儿的结果。死亡和严重残疾概率的最佳估计结合了联合收割机当地经验和公布的数据。目的：描述来自佛蒙特牛津网络（VON）ELBW婴儿随访组中心的ELBW婴儿的神经发育结局，并确定与严重残疾相关的特征。研究方法：在1998年7月1日至2003年12月31日期间，在33个北美VON中心出生的出生体重为401- 1，000 g的婴儿中，在18-24个月的校正年龄时收集预定义的生活状况、健康和发育结果的测量值。Logistic回归用于识别与严重残疾相关的特征。结果：6，198名ELBW婴儿出生并存活至出院;随访时，88名婴儿（1.4%）死亡。在其余的6，110名婴儿中，有3，567名（58.4%）接受了评估。严重残疾发生在34%的评估婴儿。多因素Logistic回归分析显示，囊性脑室周围白质软化、先天畸形和重度脑室内出血是与重度残疾最相关的特征。随访诊所之间的自然减员率存在显著差异。结论：完成评估的极低出生体重儿有发生严重残疾的高风险。参与研究的中心之间在随访时的损耗方面存在相当大的差异。将需要更多的资源来研究对这组婴儿的后续护理的效果。版权所有（C）2009 S. Karger AG，巴塞尔
Background: Physicians and parents face significant uncertainties when making care decisions for extremely low birth weight (ELBW) infants. Many published estimates of death and developmental outcome are from well-funded university programs and may not reflect outcomes of infants from a variety of settings. The best estimates of the probabilities of death and severe disability combine local experience and published data. Objective: To describe the neurodevelopmental outcome of ELBW infants from centers of the ELBW Infant Follow-Up Group of the Vermont Oxford Network (VON) and to identify characteristics associated with severe disability. Methods: Predefined measures of living situation, health and developmental outcome were collected at 18-24 months' corrected age for infants born from July 1, 1998 to December 31, 2003 with birth weights of 401-1,000 g at 33 North American VON centers. Logistic regression was used to identify characteristics associated with severe disability. Results: 6,198 ELBW infants were born and survived until hospital discharge; by the time of follow-up, 88 infants (1.4%) had died. Of the remaining 6,110 infants, 3,567 (58.4%) were evaluated. Severe disability occurred in 34% of the assessed infants. Multivariate logistic regression suggested cystic periventricular leukomalacia, congenital malformation and severe intraventricular hemorrhage were the characteristics most highly associated with severe disability. There were marked variations among the follow-up clinics in the attrition rate. Conclusion: ELBW infants completing evaluation were at a high risk for severe disability. There are considerable differences among participating centers in attrition at follow-up. Further resources will be needed to study the effect of follow-up care for this group of infants. Copyright (C) 2009 S. Karger AG, Basel