Journal Article

DOES PRETERM INFANTS BORN OUTSIDE TERTIARY PERINATAL CENTRE HAVE AN IMPACT ON NEURODEVELOPMENTAL AND GROWTH OUTCOME AT 36 MONTHS CORRECTED AGE?

Amuchou Soraisham, Ayman Sheta, Catherine Ringtham, Selphee Tang, Diane Creighton, Leonora Hendson and Abhay Lodha

in Paediatrics & Child Health

Published on behalf of Canadian Paediatric Society

Volume 23, issue suppl_1, pages e18-e19
Published in print May 2018 | ISSN: 1205-7088
Published online May 2018 | e-ISSN: 1918-1485 | DOI: https://dx.doi.org/10.1093/pch/pxy054.047
DOES PRETERM INFANTS BORN OUTSIDE TERTIARY PERINATAL CENTRE HAVE AN IMPACT ON NEURODEVELOPMENTAL AND GROWTH OUTCOME AT 36 MONTHS CORRECTED AGE?

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  • Neonatology
  • Primary Care
  • Child and Adolescent Psychiatry
  • Clinical Child and Adolescent Psychology

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Abstract

BACKGROUND

Infants born in tertiary perinatal centres (inborn) have higher survival and lower morbidity than outborn infants. However, there is limited information regarding the long term neurodevelopmental and growth outcomes among outborn preterm infants.

OBJECTIVES

To compare the neurodevelopmental and growth outcomes at 36 months corrected age (CA) between outborn and inborn infants born < 29 weeks.

DESIGN/METHODS

This is a retrospective cohort study. We included infants born <29 weeks admitted to Foothills Medical Centre, Calgary between January 2000 and December 2012, who had neurodevelopmental(ND) assessment up to 36 months CA. Infants with intrauterine infection, major congenital and chromosomal anomalies were excluded. Our primary outcome was composite of death or neurodevelopmental impairment (NDI). We compared ND and growth outcomes between inborn and the outborn infants using univariate and multivariate logistic regression analysis.

RESULTS

Of 1235 eligible infants, 175 (14%) were outborn. Outborn infants were lower in GA (25.8 ± 1.7 wk vs 26.2 ± 1.5 wk), had lower chorioamnionitis rate (15% vs 24%), received less antenatal steroid (55% vs 90%) and maternal antibiotics (51% vs 68%). Neonatal morbidities were similar between the two groups except that outborn infants had higher rates of severe brain injury (24% vs 12%) and mortality (22% vs 11%).

Of 1078 eligible survivors, 1048 (97%) were followed. There was no difference in ND outcomes (Table). Multivariate regression analysis controlling for potential confounders (GA, gender, chorioamnionitis, antenatal steroids and maternal age) showed outborn status was not associated with composite primary outcome of death or ND impairment (adjusted OR: 1.09, 95% CI, 0.69, 1.70). Growth outcomes were not significantly different between two groups.

CONCLUSION

In this cohort, neurodevelopmental and growth outcomes does not appear to be significantly different between outborn and infants at 36 months corrected age.

Journal Article.  0 words.  Illustrated.

Subjects: Neonatology ; Primary Care ; Child and Adolescent Psychiatry ; Clinical Child and Adolescent Psychology

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