No Improvement Seen in Very Premature Infants

Neurodevelopmental outcomes in those born before 25 weeks' gestation similar from '99 to '04

WEDNESDAY, Dec. 29 (HealthDay News) -- Although postnatal steroid exposure has fallen in recent years for babies born before 25 weeks' gestation, survival rates and adverse neurosensory and cognitive outcomes have changed little, according to research published online Dec. 27 in Pediatrics.

Susan R. Hintz, M.D., of the Stanford University School of Medicine in Palo Alto, Calif., and colleagues evaluated neurodevelopmental outcomes at 18 to 22 months' corrected age in infants born at an extremely low birth weight and gestational age of less than 25 weeks during two different epochs: 1999 to 2001 (epoch 1) and 2002 to 2004 (epoch 2). Data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network were collected.

The researchers found infant survival to be similar between the two epochs, at 411 of 452 (35.4 percent) in epoch 1 and 405 of 438 (32.3 percent) in epoch 2 (P = .09). Cesarean delivery, surgery for patent ductus arteriosus, and late sepsis happened more frequently in the second epoch, but postnatal steroid use was dramatically and significantly lower in that epoch (decreased from 63.5 to 32.8 percent). Adverse outcomes, such as cerebral palsy and neurodevelopmental impairment, were similar in the two epochs.

"Early-childhood outcomes for infants born at less than 25 weeks' estimated gestational age were unchanged between the two periods," the authors write.

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