Hypotension within 1 week of life associated with poor short- and long-term outcomes in very low birth weight infants

2018 ◽  
Vol 28 (8) ◽  
pp. 1037-1041
Author(s):  
Tae-Hoon Kim ◽  
Cheong-Jun Moon ◽  
In K. Sung ◽  
Young A. Youn
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Periventricular Leukomalacia ◽  
Screening Tests ◽  
Multivariable Logistic Regression Analysis ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes ◽  
Increased Risk ◽  
Overall Mortality

AbstractWe examined whether hypotension in very low birth weight infants aged⩽1 week was associated with hospital morbidities and overall mortality. Further, we studied whether hypotension was associated with poor neurodevelopmental outcomes in these patients at the corrected age of 18 months. A total of 166 very low birth weight infants were studied during this period. Hospital outcomes and neurodevelopmental outcomes at the corrected age of 18 months were evaluated. Among the 166 very low birth weight infants, 95 patients (57.2%) experienced hypotension at⩽1 week and were associated with an increased incidence of morbidities and mortality. At the corrected age of 18 months, hypotension of the⩽1 week group had significantly lower scores in all three – cognitive, language, and motor – composites of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) screening tests. In addition, a multivariable logistic regression analysis showed that longer mechanical ventilation and periventricular leukomalacia were additionally associated with worse cognitive and language neurodevelopmental outcomes. Hypotension in very low birth weight infants within 1 week of life was associated with increased morbidities and overall mortality. It was also associated with an increased risk of cognitive and language outcomes.

Outcomes of outborn very-low-birth-weight infants in Japan

2020 ◽  
pp. fetalneonatal-2019-318594
Author(s):  
Katsuya Hirata ◽  
Takeshi Kimura ◽  
Shinya Hirano ◽  
Kazuko Wada ◽  
Satoshi Kusuda ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Research Network ◽  
Low Birth Weight Infants ◽  
Inverse Probability ◽  
Antenatal Steroids ◽  
Increased Risk

BackgroundOutcomes of prenatal covariate-adjusted outborn very-low-birth-weight infants (VLBWIs) (≤1500 g) remain uncertain.ObjectiveTo compare morbidity and mortality between outborn and inborn VLBWIs.DesignObservational cohort study using inverse-probability-of-treatment weighting.SettingNeonatal Research Network of Japan.PatientsSingleton VLBWIs with no major anomalies admitted to a neonatal intensive care unit from 2012 to 2016.MethodsInverse-probability-of-treatment weighting with propensity scores was used to reduce imbalances in prenatal covariates (gestational age (GA), birth weight, small for GA, sex, maternal age, premature rupture of membranes, chorioamnionitis, preeclampsia, maternal diabetes mellitus, antenatal steroids and caesarean section). The primary outcome was severe intraventricular haemorrhage (IVH). The secondary outcomes were outcomes at resuscitation, other neonatal morbidities and mortality.ResultsThe full cohort comprised 15 842 VLBWIs (668 outborns). The median (IQR) GA and birth weight were 28.9 (26.4–31.0) weeks and 1128 (862–1351) g for outborns and 28.7 (26.3–30.9) weeks and 1042 (758–1295) g for inborns. Outborn VLBWIs had a higher incidence of severe IVH (8.2% vs 4.1%; OR, 3.45; 95% CI 1.16 to 10.3) and pulmonary haemorrhage (3.7% vs 2.8%; OR, 5.21; 95% CI 1.41 to 19.2). There were no significant differences in Apgar scores, oxygen rates at delivery, intubation ratio at delivery, persistent pulmonary hypertension of the newborn, IVH of any grade, periventricular leukomalacia, chronic lung disease, oxygen at discharge, patent ductus arteriosus, retinopathy of prematurity, necrotising enterocolitis, sepsis or mortality.ConclusionOutborn delivery of VLBWIs was associated with an increased risk of severe IVH.

scholarly journals The Prognosis of Refractory Hypotension and Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants

2021 ◽  
Author(s):  
Seok Hwang-Bo ◽  
Yu-Mi Seo ◽  
Moon-Yeon Oh ◽  
Soo-Ah Im ◽  
YoungAh Youn
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Developmental Delay ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Periventricular Leukomalacia ◽  
Pulmonary Hemorrhage ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes ◽  
Refractory Hypotension

Abstract Background: The increased survival rate among very low birth weight infants has resulted in a higher risk for developing neurocomplications such as intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) and adverse neurodevelopmental outcomes.Purpose: We examined refractory hypotension experienced within a week of life in association with severe IVH (grades 3-4) among very low birth weight infants (VLBWIs).Method: Between Jan 2014 and Dec 2017, the clinical data of 191 VLBWIs admitted were retrospectively reviewed. Of a total of 191 VLBWIs, 71.2% (136/191) had IVH, and 28.7% (55/191) had severe IVH.Results: The VLBWI with severe IVH group (grade 3-4) presented with a significantly lower gestational age along with higher use of postnatal hydrocortisone for refractory hypotension. Resuscitation at delivery, pulmonary hemorrhage, neonatal seizure, and periventricular leukomalacia (PVL) were significantly more frequent in the severe IVH group (p<0.05). Higher mortality occurred in the VLBWI with severe IVH group (p<0.001). The multivariable logistic regression analysis consistently showed that refractory hypotension within a week of life and neonatal seizures were significantly associated with severe IVH. Those in the severe IVH and refractory hypotension groups had significantly lower composite cognitive, language, motor, and Bayley Scales of Infant and Toddler Development III scores at corrected 18 months.Those in the severe IVH and refractory hypotension groups showed significant developmental delay.Conclusion: Refractory hypotension within a week of life and seizures were consistently associated with severe IVH. VLBWI who experienced refractory hypotension within a week of life may indicate a more vulnerable perinatal settings with a higher risk for developmental delay.

Lack of Effects of Oral Probiotics on Growth and Neurodevelopmental Outcomes in Preterm Very Low Birth Weight Infants

2010 ◽  
Vol 156 (3) ◽  
pp. 393-396 ◽  
Author(s):  
I-Ching Chou ◽  
Haung-Tsung Kuo ◽  
Jeng-Sheng Chang ◽  
Shu-Fen Wu ◽  
Hsiao-Yu Chiu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes

Implementation of Potentially Better Practices for the Prevention of Brain Hemorrhage and Ischemic Brain Injury in Very Low Birth Weight Infants

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e497-e503
Author(s):  
Debra McLendon ◽  
Jennifer Check ◽  
Patricia Carteaux ◽  
Laura Michael ◽  
Jim Moehring ◽  
...  
Keyword(s):  
Birth Weight ◽  
Brain Injury ◽  
Low Birth Weight ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Periventricular Leukomalacia ◽  
Communication Education ◽  
Low Birth Weight Infants ◽  
Head Positioning ◽  
Ventilator Management

Objective. Using an evidence-based approach, a Vermont Oxford Network focus group whose goal was to reduce brain injury developed and implemented a number of potentially better practices. Each center approached implementation of the practices differently. Reducing the incidence of intraventricular hemorrhage and periventricular leukomalacia are important for improving long-term outcomes for low birth weight infants. Methods. Implementation approaches for some but not all of the practices at the various centers are discussed. The practices reviewed include optimal peripartum management, such as resuscitation, avoidance of hypothermia, optimal surfactant delivery, early neonatal management by the most experienced providers, and measures to minimize pain and stress. Additional practices include maintenance of neutral head positioning, fluid volume therapy for hypotension, indomethacin prophylaxis, ventilator management, avoidance of routine suctioning, and limiting the use of sodium bicarbonate and postnatal dexamethasone. Results. Approaches to implementation were center specific, and results vary. Although some practices were easier to implement than others, communication, education, and leadership were critical to the process. Conclusions. The quality improvement multidisciplinary approach is a useful tool for finding ways to reduce the incidence of intraventricular hemorrhage and periventricular leukomalacia.

Neurodevelopmental Outcomes in Very Low-Birth-Weight Infants in Korea

2011 ◽  
Vol 26 (11) ◽  
pp. 1405-1410 ◽  
Author(s):  
Dae-Hyun Jang ◽  
In Young Sung ◽  
Jae Yong Jeon ◽  
Hye Jin Moon ◽  
Ki-Soo Kim ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
Survival Rate ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes ◽  
Recent Group ◽  
Neurodevelopmental Impairment ◽  
Over Time

The authors reviewed the medical records of very low-birth-weight infants admitted from 1998 to 2007 and compared neurodevelopmental outcomes with their previously reported data from 1989 to 1997. The recent group included 824 infants, and the previous group included 471 infants. Neurodevelopmental outcomes were classified into cerebral palsy and non–cerebral palsy neurodevelopmental impairment. In the recent group, the survival rate was significantly higher (79.4% vs 66.2%), the rate of cerebral palsy was lower (7.9% vs 10.5%), and the rate of non–cerebral palsy neurodevelopmental impairment was higher (6.0% vs 4.5%) but not significant. The survival rate increased significantly over time, but there was no significant change in neurodevelopmental outcomes over time. Multivariate analysis indicated that abnormal neurosonographic findings, using assisted ventilation, vaginal delivery, and abnormal brainstem auditory evoked potential, were associated with increased risk for cerebral palsy.

scholarly journals Neurodevelopmental Outcomes in Very Low Birth Weight Infants Using Aminophylline for the Treatment of Apnea

2016 ◽  
Vol 57 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Shu-Leei Tey ◽  
Wei-Te Lee ◽  
Pei-Lun Lee ◽  
Chu-Chong Lu ◽  
Hsiu-Lin Chen
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes

scholarly journals Incidence of bronchopulmonary dysplasia and mortality of very low birth weight infants in Vojvodina

2020 ◽  
Vol 148 (1-2) ◽  
pp. 52-57
Author(s):  
Gordana Vilotijevic-Dautovic ◽  
Aleksandra Doronjski ◽  
Gordana Vijatov-Djuric ◽  
Milena Bjelica
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Very Low Birth Weight ◽  
Developed Countries ◽  
Supplemental Oxygen ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Original Definition ◽  
Overall Mortality

Introduction/Objective. The incidence of bronchopulmonary dysplasia (BPD) varies depending on the prematurity rate, definition, and therapy that are applied at a certain center. The average incidence of BPD for very low birth weight infants (VLBW) in developed countries ranges 4?53%. The mortality of VLBW infants is high and represents 50% of the total neonatal and infant mortality. In recent years, the survival limits are shifted towards lower gestations. The aim of our study was to determine the incidence and severity of BPD in VLBW infants in Vojvodina and the overall mortality. Methods. This retrospective study was conducted from January 2006 to December 2011 and included 504 infants with birth weight < 1,500 g. Results. In the total premature infants? population, 82.3% survived by the gestational age of 36 weeks. According to the original definition of BPD, as supplemental oxygen use at 28 days of life, BPD had 45.4% of infants. According to the severity based definition 19.4% had mild BPD, 19.8% moderate BPD and 6.5% severe BPD. If BPD is observed as supplemental oxygen use at 36 weeks postmenstrual age, BPD had 26% of infants. Conclusion. The overall mortality and incidence of BPD in our study are comparable to those in some developed countries and lower compared to underdeveloped countries.

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