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Doctors Have New Assessment Tool in Cases of Prematurity
| Author: Tony Cappasso |
| Article Date: 4/22/2008 |
Physicians who treat extremely premature babies have new tools to assess their patients and decide on appropriate levels of care.
According to researchers, assessing gender, exposure or non-exposure to antenatal corticosteroids, single or multiple birth and birth weight should be taken into consideration, along with gestational age in determining treatment. The research team published its conclusions in the April 16 issue of the New England Journal of Medicine.
The scientists studied more than 4000 infants born between 22 and 25 weeks gestational age at 19 hospitals in the Neonatal Research Network of the National Institute of child Health and Human Development.
Among study infants, 3702 (83 percent) received intensive care in the form of mechanical ventilation. Among the 4192 study infants (94 percent) for whom outcomes were determined at 18 to 22 months, 49 percent died, 61 percent died or had profound impairment, and 73 percent died or had impairment.
In multivariable analyses of infants who received intensive care, exposure to antenatal corticosteroids, female sex, singleton birth, and higher birth weight (per each 100-g increment) were each associated with reductions in the risk of death and the risk of death or profound or any neuro-developmental impairment.
These reductions were similar to those associated with a one-week increase in gestational age. At the same estimated likelihood of a favorable outcome, girls were less likely than boys to receive intensive care. The outcomes for infants who underwent ventilation were better predicted with the use of the above factors than with use of gestational age alone.
The researchers conclude that taking gender, birth number, birth weight and corticosteroid drug administration should also be considered along with gestational age measurements by the best available method in making treatment determinations.
Source: New England Journal of Medicine, April 16, 2008
According to researchers, assessing gender, exposure or non-exposure to antenatal corticosteroids, single or multiple birth and birth weight should be taken into consideration, along with gestational age in determining treatment. The research team published its conclusions in the April 16 issue of the New England Journal of Medicine.
The scientists studied more than 4000 infants born between 22 and 25 weeks gestational age at 19 hospitals in the Neonatal Research Network of the National Institute of child Health and Human Development.
Among study infants, 3702 (83 percent) received intensive care in the form of mechanical ventilation. Among the 4192 study infants (94 percent) for whom outcomes were determined at 18 to 22 months, 49 percent died, 61 percent died or had profound impairment, and 73 percent died or had impairment.
In multivariable analyses of infants who received intensive care, exposure to antenatal corticosteroids, female sex, singleton birth, and higher birth weight (per each 100-g increment) were each associated with reductions in the risk of death and the risk of death or profound or any neuro-developmental impairment.
These reductions were similar to those associated with a one-week increase in gestational age. At the same estimated likelihood of a favorable outcome, girls were less likely than boys to receive intensive care. The outcomes for infants who underwent ventilation were better predicted with the use of the above factors than with use of gestational age alone.
The researchers conclude that taking gender, birth number, birth weight and corticosteroid drug administration should also be considered along with gestational age measurements by the best available method in making treatment determinations.
Source: New England Journal of Medicine, April 16, 2008