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Major congenital anomalies place extremely low birth weight infants at higher risk for poor growth and developmental outcomes.
Pediatrics. 2007 Dec; 120(6):e1512-9.Ped

Abstract

BACKGROUND

Studies of growth and neurodevelopmental impairment in extremely low birth weight infants often exclude infants with major congenital anomalies; thus, there are few outcome data available on these infants.

OBJECTIVES

The purpose of this work was to compare growth and neurodevelopmental outcomes of extremely low birth weight infants with major anomalies to extremely low birth weight infants without these findings. It was hypothesized that infants with severe anomalies would have worse growth, neurodevelopmental, and survival outcomes.

METHODS

A retrospective cohort analysis was performed on 5920 extremely low birth weight infants surviving beyond 12 hours of life at 19 neonatal network centers between 1998 and 2001. Infants with significant anomalies were more likely to die before 18 to 22 months' corrected age. A total of 3705 children underwent neurodevelopmental and anthropometric evaluation at 18 to 22 months' corrected age. Statistical significance for unadjusted comparisons was determined by Wilcoxon tests for continuous variables and chi2 or Fisher's exact tests for categorical variables. Regression models were used to compare the outcomes after adjusting for potential confounders.

RESULTS

Children with major congenital anomalies were more likely to have Bayley Mental Development Index scores of < or = 70, Psychomotor Development Index scores of < or = 70, neurodevelopmental impairment, moderate-to-severe cerebral palsy, length in the < or = 10th percentile, head circumference in the < or = 10th percentile, more rehospitalizations, and higher rates of early intervention use at 18 to 22 months' corrected age.

CONCLUSIONS

At 18 to 22 months' corrected age, extremely low birth weight infants born with major anomalies have nearly twice the risk for neurodevelopmental impairment, increased risk of poor growth, and > 3 times greater risk of rehospitalization when compared with extremely low birth weight infants without major anomalies. This information may be valuable for counseling parents regarding the outcomes of these infants and for the facilitation of appropriate support and intervention services.

Authors+Show Affiliations

Pediatrix Medical Group of Dallas, Richardson, Texas, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17984212

Citation

Walden, Rachel V., et al. "Major Congenital Anomalies Place Extremely Low Birth Weight Infants at Higher Risk for Poor Growth and Developmental Outcomes." Pediatrics, vol. 120, no. 6, 2007, pp. e1512-9.
Walden RV, Taylor SC, Hansen NI, et al. Major congenital anomalies place extremely low birth weight infants at higher risk for poor growth and developmental outcomes. Pediatrics. 2007;120(6):e1512-9.
Walden, R. V., Taylor, S. C., Hansen, N. I., Poole, W. K., Stoll, B. J., Abuelo, D., & Vohr, B. R. (2007). Major congenital anomalies place extremely low birth weight infants at higher risk for poor growth and developmental outcomes. Pediatrics, 120(6), e1512-9.
Walden RV, et al. Major Congenital Anomalies Place Extremely Low Birth Weight Infants at Higher Risk for Poor Growth and Developmental Outcomes. Pediatrics. 2007;120(6):e1512-9. PubMed PMID: 17984212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Major congenital anomalies place extremely low birth weight infants at higher risk for poor growth and developmental outcomes. AU - Walden,Rachel V, AU - Taylor,Sarah C, AU - Hansen,Nellie I, AU - Poole,W Kenneth, AU - Stoll,Barbara J, AU - Abuelo,Dianne, AU - Vohr,Betty R, AU - ,, Y1 - 2007/11/05/ PY - 2007/11/7/pubmed PY - 2008/1/8/medline PY - 2007/11/7/entrez SP - e1512 EP - 9 JF - Pediatrics JO - Pediatrics VL - 120 IS - 6 N2 - BACKGROUND: Studies of growth and neurodevelopmental impairment in extremely low birth weight infants often exclude infants with major congenital anomalies; thus, there are few outcome data available on these infants. OBJECTIVES: The purpose of this work was to compare growth and neurodevelopmental outcomes of extremely low birth weight infants with major anomalies to extremely low birth weight infants without these findings. It was hypothesized that infants with severe anomalies would have worse growth, neurodevelopmental, and survival outcomes. METHODS: A retrospective cohort analysis was performed on 5920 extremely low birth weight infants surviving beyond 12 hours of life at 19 neonatal network centers between 1998 and 2001. Infants with significant anomalies were more likely to die before 18 to 22 months' corrected age. A total of 3705 children underwent neurodevelopmental and anthropometric evaluation at 18 to 22 months' corrected age. Statistical significance for unadjusted comparisons was determined by Wilcoxon tests for continuous variables and chi2 or Fisher's exact tests for categorical variables. Regression models were used to compare the outcomes after adjusting for potential confounders. RESULTS: Children with major congenital anomalies were more likely to have Bayley Mental Development Index scores of < or = 70, Psychomotor Development Index scores of < or = 70, neurodevelopmental impairment, moderate-to-severe cerebral palsy, length in the < or = 10th percentile, head circumference in the < or = 10th percentile, more rehospitalizations, and higher rates of early intervention use at 18 to 22 months' corrected age. CONCLUSIONS: At 18 to 22 months' corrected age, extremely low birth weight infants born with major anomalies have nearly twice the risk for neurodevelopmental impairment, increased risk of poor growth, and > 3 times greater risk of rehospitalization when compared with extremely low birth weight infants without major anomalies. This information may be valuable for counseling parents regarding the outcomes of these infants and for the facilitation of appropriate support and intervention services. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/17984212/Major_congenital_anomalies_place_extremely_low_birth_weight_infants_at_higher_risk_for_poor_growth_and_developmental_outcomes_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=17984212 DB - PRIME DP - Unbound Medicine ER -