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Influence of obstetric management on outcome of extremely preterm growth retarded infants
  1. A H P Schaapa,
  2. H Wolfa,
  3. H W Bruinsec,
  4. A L den Oudene,
  5. H Smolders-de Haasb,
  6. I van Ertbruggend,
  7. P E Treffersa
  1. aDepartment of Obstetrics, bDepartment of Neonatology, Academic Medical Centre, University of Amsterdam, cDepartment of Obstetrics, University Hospital, Utrecht, dDepartment of Neonatology, Wilhelmina Children’s Hospital, Utrecht, eTNO Institute of Preventive Health Care, Leiden
  1. Dr AHP Schaap, PO Box 22700, 1100 DE Amsterdam, The Netherlands.

Abstract

AIM To describe the long term outcome of extremely preterm growth retarded infants in relation to obstetric management and various perinatal events.

METHODS A cohort study was undertaken in two tertiary care centres with different obstetric management. All infants with fetal growth retardation due to placental insufficiency and resulting in fetal distress at 26 to 32 weeks of gestation, were included for the years 1984–89. Main outcome measures were impairment, disability, or handicap at 2 years corrected age and at school age (4 ½ to 10 ½ years).

RESULTS One hundred and twenty five (98%) were followed up until 2 years corrected age in the outpatient department; 114 (90%) were assessed at school age. Impairments were found in 37% and disabilities or handicaps in 9% of the assessed infants, with no difference between centres. All disabled or handicapped children had already been identified by 2 years corrected age.

CONCLUSIONS Disability or handicap were related to neonatal complications (intracerebral haemorrhage or bronchopulmonary dysplasia) and not to obstetric variables, thus making antenatal prediction impossible. The incidence of disability or handicap in these growth retarded infants was comparable with that of other preterm infants.

  • growth retardation
  • disability
  • handicap
  • obstetric variables

https://doi.org/10.1136/fn.77.2.F95

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