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Increased survival and deteriorating developmental outcome in 23 to 25 week old gestation infants, 1990-4 compared with 1984-9

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Increased survival and deteriorating developmental outcome in 23 to 25 week old gestation infants, 1990-4 compared with 1984-9. / Emsley, H. C A; Wardle, S. P.; Sims, D. G. et al.
In: Archives of Disease in Childhood: Fetal and Neonatal Edition, Vol. 78, No. 2, 02.1998, p. F99-F102.

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Harvard

Emsley, HCA, Wardle, SP, Sims, DG, Chiswick, ML & D'Souza, SW 1998, 'Increased survival and deteriorating developmental outcome in 23 to 25 week old gestation infants, 1990-4 compared with 1984-9', Archives of Disease in Childhood: Fetal and Neonatal Edition, vol. 78, no. 2, pp. F99-F102. https://doi.org/10.1136/fn.78.2.F99

APA

Emsley, H. C. A., Wardle, S. P., Sims, D. G., Chiswick, M. L., & D'Souza, S. W. (1998). Increased survival and deteriorating developmental outcome in 23 to 25 week old gestation infants, 1990-4 compared with 1984-9. Archives of Disease in Childhood: Fetal and Neonatal Edition, 78(2), F99-F102. https://doi.org/10.1136/fn.78.2.F99

Vancouver

Emsley HCA, Wardle SP, Sims DG, Chiswick ML, D'Souza SW. Increased survival and deteriorating developmental outcome in 23 to 25 week old gestation infants, 1990-4 compared with 1984-9. Archives of Disease in Childhood: Fetal and Neonatal Edition. 1998 Feb;78(2):F99-F102. doi: 10.1136/fn.78.2.F99

Author

Emsley, H. C A ; Wardle, S. P. ; Sims, D. G. et al. / Increased survival and deteriorating developmental outcome in 23 to 25 week old gestation infants, 1990-4 compared with 1984-9. In: Archives of Disease in Childhood: Fetal and Neonatal Edition. 1998 ; Vol. 78, No. 2. pp. F99-F102.

Bibtex

@article{9e823cc5877f4e63a6071d3050a30f0d,
title = "Increased survival and deteriorating developmental outcome in 23 to 25 week old gestation infants, 1990-4 compared with 1984-9",
abstract = "Aims - To assess whether changes in survival over time in infants of 23 to 25 weeks of gestational age were accompanied by changes in the incidence of disability in childhood during an 11 year period. Methods - Obstetric and neonatal variables having the strongest association with both survival to discharge from a regional neonatal medical unit and neurodevelopmental disability in 192 infants of 23 to 25 weeks of gestation, born in 1984 to 1994, were studied as a group and in two cohorts (1984 to 1989 n = 96 and 1990 to 1994 n = 96). The data collected included CRIB (clinical risk index for babies) scores and cranial ultrasound scan findings. The children were followed up at outpatient clinics. Results - Between 1984 and 1989 (cohort 1) and 1990 and 1994 (cohort 2) the rate of survival to discharge increased significantly from 27% to 42% and the rate of disability in survivors increased from 38% to 68% ; most of this increase was in mild disability. The proportions of survivors with cerebral palsy did not alter significantly (21% vs 18%), but more survivors with blindness due to retinopathy of prematurity (4% vs 18%), myopia (4% vs 15%) and squints (8% vs 13%) contributed to the increased rate of disability. Clinically significant cranial ultrasound findings and a high CRIB score were strongly associated with death. A high CRIB score was most strongly associated with disability. Conclusions - The rise in disability with improved survival was not due to cerebral palsy; rather the main contributors were blindness due to retinopathy, myopia, and squint. The causes of these disabilities seem to be linked to high CRIB scores. A system of regular and skilled retinal examination and access to facilities for retinal ablation should be in place in all neonatal units which undertake the care of such extremely preterm infants.",
keywords = "Blindness, CRIB scores, Extremely preterm infants, Neurodevelopmental disability, Survival",
author = "Emsley, {H. C A} and Wardle, {S. P.} and Sims, {D. G.} and Chiswick, {M. L.} and D'Souza, {S. W.}",
year = "1998",
month = feb,
doi = "10.1136/fn.78.2.F99",
language = "English",
volume = "78",
pages = "F99--F102",
journal = "Archives of Disease in Childhood: Fetal and Neonatal Edition",
issn = "1359-2998",
publisher = "BMJ Publishing Group",
number = "2",

}

RIS

TY - JOUR

T1 - Increased survival and deteriorating developmental outcome in 23 to 25 week old gestation infants, 1990-4 compared with 1984-9

AU - Emsley, H. C A

AU - Wardle, S. P.

AU - Sims, D. G.

AU - Chiswick, M. L.

AU - D'Souza, S. W.

PY - 1998/2

Y1 - 1998/2

N2 - Aims - To assess whether changes in survival over time in infants of 23 to 25 weeks of gestational age were accompanied by changes in the incidence of disability in childhood during an 11 year period. Methods - Obstetric and neonatal variables having the strongest association with both survival to discharge from a regional neonatal medical unit and neurodevelopmental disability in 192 infants of 23 to 25 weeks of gestation, born in 1984 to 1994, were studied as a group and in two cohorts (1984 to 1989 n = 96 and 1990 to 1994 n = 96). The data collected included CRIB (clinical risk index for babies) scores and cranial ultrasound scan findings. The children were followed up at outpatient clinics. Results - Between 1984 and 1989 (cohort 1) and 1990 and 1994 (cohort 2) the rate of survival to discharge increased significantly from 27% to 42% and the rate of disability in survivors increased from 38% to 68% ; most of this increase was in mild disability. The proportions of survivors with cerebral palsy did not alter significantly (21% vs 18%), but more survivors with blindness due to retinopathy of prematurity (4% vs 18%), myopia (4% vs 15%) and squints (8% vs 13%) contributed to the increased rate of disability. Clinically significant cranial ultrasound findings and a high CRIB score were strongly associated with death. A high CRIB score was most strongly associated with disability. Conclusions - The rise in disability with improved survival was not due to cerebral palsy; rather the main contributors were blindness due to retinopathy, myopia, and squint. The causes of these disabilities seem to be linked to high CRIB scores. A system of regular and skilled retinal examination and access to facilities for retinal ablation should be in place in all neonatal units which undertake the care of such extremely preterm infants.

AB - Aims - To assess whether changes in survival over time in infants of 23 to 25 weeks of gestational age were accompanied by changes in the incidence of disability in childhood during an 11 year period. Methods - Obstetric and neonatal variables having the strongest association with both survival to discharge from a regional neonatal medical unit and neurodevelopmental disability in 192 infants of 23 to 25 weeks of gestation, born in 1984 to 1994, were studied as a group and in two cohorts (1984 to 1989 n = 96 and 1990 to 1994 n = 96). The data collected included CRIB (clinical risk index for babies) scores and cranial ultrasound scan findings. The children were followed up at outpatient clinics. Results - Between 1984 and 1989 (cohort 1) and 1990 and 1994 (cohort 2) the rate of survival to discharge increased significantly from 27% to 42% and the rate of disability in survivors increased from 38% to 68% ; most of this increase was in mild disability. The proportions of survivors with cerebral palsy did not alter significantly (21% vs 18%), but more survivors with blindness due to retinopathy of prematurity (4% vs 18%), myopia (4% vs 15%) and squints (8% vs 13%) contributed to the increased rate of disability. Clinically significant cranial ultrasound findings and a high CRIB score were strongly associated with death. A high CRIB score was most strongly associated with disability. Conclusions - The rise in disability with improved survival was not due to cerebral palsy; rather the main contributors were blindness due to retinopathy, myopia, and squint. The causes of these disabilities seem to be linked to high CRIB scores. A system of regular and skilled retinal examination and access to facilities for retinal ablation should be in place in all neonatal units which undertake the care of such extremely preterm infants.

KW - Blindness

KW - CRIB scores

KW - Extremely preterm infants

KW - Neurodevelopmental disability

KW - Survival

U2 - 10.1136/fn.78.2.F99

DO - 10.1136/fn.78.2.F99

M3 - Journal article

C2 - 9577278

AN - SCOPUS:0031943477

VL - 78

SP - F99-F102

JO - Archives of Disease in Childhood: Fetal and Neonatal Edition

JF - Archives of Disease in Childhood: Fetal and Neonatal Edition

SN - 1359-2998

IS - 2

ER -