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146: Antenatal variables and infant neurodevelopmental damage (ND) among babies with birth weight <1500 grams

      Objective

      To determine the association between antenatal factors and neurodevelopmental damage in preterm infants.

      Study Design

      A cohort of babies born at <34.0 week gestation over a 8 year period with a weight <1500 grams underwent neurodevelopmental follow up. Obstetric and perinatal predictors, including clinical and histological signs of infection were analyzed using logistic regression analysis and related to neurodevelopmental delay (ND)including cerebral palsy.

      Results

      86.5% (n=225) of babies who survived underwent follow up for a median of 24 months (range 12-96) and 39 (17.3%) had ND. Only birth weight <1000 g (3.7 95%CI 1.7-7.7) and SGA (OR=0.3, 95% CI 0.2-0.7) were independently related to ND. Of interest, neither clinical or placental evidence of intrauterine infection was independently predictive of ND; however, infection was significantly correlated with lower gestational age at delivery (p=0.004, r=-0.36).

      Conclusion

      Lower birth weight is a risk factor and SGA a protective factor for development of ND. Intrauterine infection is not directly related to ND, but its effect may be mediated by lower gestational age at delivery.
      Tabled 1
      Univariate analysis
      ND yesND nop
      n=39n=186
      GA at delivery28.3±229.5±20.009
      Birth-weight982±2641105±2650.002
      SGA13%31%0.02
      Histologic chorioamnionitis20%29%0.3
      Clinical chorioamnionitis5%7%1
      PROM28%19%0.2