Serum Bilirubin Levels, Intracranial Hemorrhage, and the Risk of Developmental Problems in Very Low Birth Weight Neonates

PEDIATRICS ◽  
1992 ◽  
Vol 90 (6) ◽  
pp. 888-892
Author(s):  
T. Michael O'Shea ◽  
Robert G. Dillard ◽  
Kurt L. Klinepeter ◽  
Donald J. Goldstein
Keyword(s):  
Logistic Regression ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intracranial Hemorrhage ◽  
Very Low Birth Weight ◽  
Confounding Factors ◽  
Developmental Problems ◽  
Period Increase ◽  
Developmental Index ◽  
Mental Developmental Index

To study whether elevated levels of bilirubin in the neonatal period increase the risk of developmental problems for very low birth weight neonates, the investigators used data from a geographically based sample of 495 very low birth weight neonates, born January 1, 1985, to December 31, 1989, who survived to 1 year of adjusted age. Maximum neonatal bilirubin levels were found in medical records. A developmental problem was defined as either cerebral palsy or a Bayley Mental Developmental Index of less than 68 at 1 year adjusted age. Potentially confounding factors were controlled using logistic regression. To control for the effects of intracranial abnormalities (eg, intraventricular hemorrhage), separate logistic regression analyses were carried out for three strata, defined according to the results of cranial ultrasonography. In these analyses, the following odds ratios (with 95% confidence limits) were found for the association of maximum neonatal bilirubin concentration and developmental problems: for subjects without intracranial abnormalities, 0.9 (0.7, 1.9); for subjects with uncomplicated intracranial hemorrhage, 1.5 (0.8, 2.5); for subjects with complicated intracranial hemorrhage or intraparenchymal echodensities, 1.2 (0.4, 3.6). In summary, in analyses controlled for confounding factors, maximum neonatal bilirubin level was not consistently associated with the risk of developmental problems identifiable at 1 year.

scholarly journals Clinical profile and factors determining outcome of intramural very low birth weight babies in a tertiary care centre: a retrospective study

2017 ◽  
Vol 5 (2) ◽  
pp. 520
Author(s):  
Devi Meenakshi K. ◽  
Arasar Seeralar A. T. ◽  
Srinivasan Padmanaban
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Logistic Regression Analysis ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
P Value ◽  
Increased Risk

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality.

Brainstem auditory evoked potentials in very-low-birth-weight neonates with intracranial hemorrhage

1986 ◽  
Vol 14 (1) ◽  
pp. 9-17 ◽  
Author(s):  
Caryl J. Semmler ◽  
Robert E. Lasky ◽  
Ann Maravilla ◽  
Sharon Dowling ◽  
Charles R. Rosenfeld
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Evoked Potentials ◽  
Intracranial Hemorrhage ◽  
Auditory Evoked Potentials ◽  
Very Low Birth Weight ◽  
Brainstem Auditory Evoked Potentials

Exchange transfusion and hypernatremia: Possible role in intracranial hemorrhage in very-low-birth-weight infants

1978 ◽  
Vol 92 (5) ◽  
pp. 848-849 ◽  
Author(s):  
Peter E. Doyle ◽  
Arthur I. Eidelman ◽  
Kwang-sun Lee ◽  
Cecelia Daum ◽  
Lawrence M. Gartner
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Intracranial Hemorrhage ◽  
Exchange Transfusion ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants

Complicated Intubations are Associated with Bronchopulmonary Dysplasia in Very Low Birth Weight Infants

2021 ◽  
Author(s):  
Tara Glenn ◽  
Linnea Fischer ◽  
Ashley Markowski ◽  
Cara Beth Carr ◽  
Sindhoosha Malay ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Very Low Birth Weight ◽  
Cumulative Number ◽  
Vlbw Infants ◽  
Post Hoc Analysis ◽  
Multivariable Logistic Regression ◽  
Post Hoc

Objective This study aimed to evaluate the association between desaturation <60% (severe desaturation) during intubation and a total number of intubation attempts in the first week of life in very low birth weight (VLBW) infants with adverse long-term outcomes including bronchopulmonary dysplasia (BPD) and severe periventricular/intraventricular hemorrhage grade 3 or 4 (PIVH). Study Design A retrospective chart review was performed on VLBW infants intubated in the neonatal intensive care unit during the first week of life between January 2017 and July 2020. Descriptive tables were generated for two outcomes including BPD and PIVH. Multivariable logistic regression was performed for each outcome including significant predictors that differed between groups with a p-value of <0.2. Results A total of 146 patients were included. Patients with BPD or PIVH had a lower gestational age, and patients with BPD had a lower BW. Patients with BPD had a greater number of intubation attempts in the first week of life (4 vs. 3, p < 0.001). In multivariable logistic regression controlling for confounding variables, the odds developing BPD were higher for patients with increased cumulative number of intubation attempts in the first week of life (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.03–1.62, p = 0.029). Post hoc analyses revealed increased odds of developing BPD with increased number of intubation encounters in the first week of life (OR: 2.20, 95% CI: 1.04–4.82, p = 0.043). In this post hoc analysis including intubation encounters in the model; desaturation <60% during intubation in the first week of life was associated with increased odds of developing BPD (OR: 2.35, 95% CI: 1.02–5.63, p = 0.048). Conclusion The odds of developing BPD for VLBW infants were higher with increased intubation attempts and intubation encounters. In a post hoc analysis, the odds of developing BPD were also higher with desaturation during intubation. Further research is needed to determine mechanisms of the relationship between complicated intubations and the development of BPD. Key Points

Preterm Infant Care After Hospital Discharge

1989 ◽  
Vol 10 (7) ◽  
pp. 195-206
Author(s):  
Judy C. Bernbaum ◽  
Susan Friedman ◽  
Marsha Hoffman Williamson ◽  
JoAnn D'Agostino ◽  
Anne Farran
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Pediatric Population ◽  
The United States ◽  
Low Birth Weight Infants ◽  
Developmental Problems ◽  
Developmental Progress ◽  
Neurologic Disorders ◽  
Physical Examinations

The survival of low birth weight infants has been markedly altered by the improvements in neonatal care. Despite these advances, little progress has been made in reducing the incidence of prematurity and low birth weight. Recently available statistics from 1983 indicate that, of all live births, 9.2% were premature (&lt;37 weeks' gestation) and 1.8% were very premature (&lt;32 weeks's gestation). Approximately 6% of infants are born weighing &lt;2,500 g and 1.1% are very low birth weight (&lt;1500 g). Approximately 3.6% of babies born in the United States are both premature and of low birth weight, and 0.8% are VLBW and very premature. Despite these relatively small numbers, this population comprises a disproportionately high percentage of children with medical, neurologic, and developmental problems. It is clear that, as more infants with low birth weights enter the pediatric population, pediatricians must become more expert in managing the medical conditions of these infants, recognizing early signs of neurologic disorders and monitoring their developmental progress. Routine physical examinations are usually not sufficient for such children. More time is generally needed to assess them and to discuss them with their parents than the typical well child. Physicians can play a major role in the identification of problems early in their evolution.

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