MS(Med), Child Health: Neurodevelopment, Faculty of Health Sciences, University of the Witwatersrand / Background:
ELBW preterm infants are at extremely high risk for adverse neurodevelopmental
(ND) outcome. Systemic hypotension is an important peri-natal risk factor in
neurodevelopmental outcome. Numerous other risk factors exist for adverse
neurodevelopmental outcome.
Aim:
To assess whether early mean systemic blood pressure and other risk factors
contribute to poor ND outcome in ELBW preterm infants managed at Panorama
Medi-Clinic.
Methods:
A retrospective, analytical study using data obtained from 2003 to 2008. Data
from the Vermont Oxford Network database of which Panorama Medi-Clinic is a
member was used to select a cohort of inborn, surviving infants weighing ≤ 1000g
or ≤ 30 weeks gestational age. Early mean systemic BP records were obtained
from nursing records. ND data was obtained from the neurodevelopmental clinic or
routine follow up clinics notes. Infants with major defects at birth were excluded.
The cohort was classified according to their general developmental quotient and
whether or not they had signs of cerebral palsy into a normal or abnormal
neurodevelopmental group. All patients remained completely anonymous and
ethical clearance was obtained from the ethics committee at Panorama Medi-
Clinic.
P a g e | VII
Results:
82 infants were eligible. 78 were entered the study. 4 were lost to follow up.
Average birth weight was 782.1g ± 148.23. Average gestational age was 27.06w ±
1.32. Normal neurodevelopmental outcome was found in 64(82%). An abnormal
neurodevelopmental outcome was found in 14(18%).
No statistically significant difference was found by logistical regression when mean
systemic blood was compared between normal and abnormal neurodevelopmental
groups.
If a cut off BP of <30 mm Hg, or inotropic agents were administered, no statistical
difference was found between the normal and abnormal groups.
Severe grades of IVH, ROP, post-natal steroids, and chronic lung disease, and
gastro-intestinal perforation, were identified as risk factor of adverse outcome
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/9052 |
| Date | 18 February 2011 |
| Creators | Alexander, Richard John |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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