AI Article Synopsis
- Neonatal morbidities such as bronchopulmonary dysplasia (BPD), brain injury, and severe retinopathy of prematurity (ROP) impact long-term outcomes in extremely preterm infants born before 26 weeks' gestation; however, only brain injury and severe ROP independently predict poor outcomes at age 11.
- Among the 247 infants studied, data showed that the presence of multiple morbidities significantly increased the likelihood of poor outcomes, with rates of poor outcomes escalating from 10% to 80% as the number of morbidities increased.
- The study emphasizes the importance of ongoing research aimed at preventing severe ROP and brain injury in preterm infants to improve their long-term health and functional abilities.
Article Abstract
Background: Uncertainty continues regarding the extent to which neonatal morbidities predict poor long-term outcome and functional abilities in extremely preterm infants.
Objective: The goal of this study was to determine the impact of bronchopulmonary dysplasia (BPD), ultrasonographic signs of brain injury, and severe retinopathy of prematurity (ROP) on 11-year outcomes in infants born at <26 weeks' gestation.
Methods: A total of 247 infants were born alive before 26 completed weeks of gestation from 1990 through 1992 in all of Sweden, and 98 (40%) survived to a postmenstrual age of 36 weeks. Main outcome measures were (1) poor outcome, defined as combined end point of death after 36 weeks' postmenstrual age or survival with at least 1 major disability at 11 years, and (2) consequences of chronic conditions in the survivors according to a validated instrument administered to parents.
Results: Brain injury and severe ROP but not BPD correlated independently with poor outcome at 11 years of age. Among children who were free from BPD, brain injury, and severe ROP, 10% had a poor outcome. Corresponding rates with any 1, any 2, and all 3 neonatal morbidities were 19%, 58%, and 80%, respectively. Multivariate analysis revealed that brain injury and severe ROP were associated with high rates of consequences of chronic conditions.
Conclusions: In infants born extremely preterm who survive to a postmenstrual age of 36 weeks, severe ROP and brain injury separately predict the risk of death or major disability at 11 years of age. Thus, continued research to determine how to prevent these complications of prematurity is critical.
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