TY - JOUR
T1 - Combination of early perinatal factors to identify near-term and term neonates for neuroprotection
AU - Talati, Ajay J.
AU - Yang, Wenjian
AU - Yolton, Kimberly
AU - Korones, Sheldon B.
AU - Bada, Henrietta S.
PY - 2005/4
Y1 - 2005/4
N2 - Objective: To determine early predictors of abnormal outcome at ≥24 months' age in neonates at risk for hypoxic-ischemic brain injury. Study design: A prospective cohort study with developmental follow-up of ≥24 months. Infants were selected based on risk factors, and neurologic outcome was determined. Variables affecting the outcome were evaluated with univariate and multivariate methods, and a scoring system was devised to predict adverse outcome. Results: A total of 41 infants born ≥35 weeks' gestational age with possibility of hypoxic-ischemic insult Were enrolled. In all, 39 (95%) had known outcomes, of whom 17 (48%) had an abnormal neurologic outcome, including five deaths. The variables within the first hour of life correlating with the adverse outcome were 1- and 5-minute Apgar scores, intubation in the delivery room and cord/initial base-deficit ≥20 mmol/l. A scoring system was derived based on significant variables, and a score ≥5 had a 90% positive predictive value for abnormal outcome. Seizures, multiorgan failure and abnormal imaging studies were also significantly associated with abnormal outcome. Conclusions: The proposed scoring system, being highly predictive of outcome at 24 months' age, may be potentially useful in selecting subjects for preventive or therapeutic interventions to prevent or minimize neurologic morbidity due to hypoxic brain injury.
AB - Objective: To determine early predictors of abnormal outcome at ≥24 months' age in neonates at risk for hypoxic-ischemic brain injury. Study design: A prospective cohort study with developmental follow-up of ≥24 months. Infants were selected based on risk factors, and neurologic outcome was determined. Variables affecting the outcome were evaluated with univariate and multivariate methods, and a scoring system was devised to predict adverse outcome. Results: A total of 41 infants born ≥35 weeks' gestational age with possibility of hypoxic-ischemic insult Were enrolled. In all, 39 (95%) had known outcomes, of whom 17 (48%) had an abnormal neurologic outcome, including five deaths. The variables within the first hour of life correlating with the adverse outcome were 1- and 5-minute Apgar scores, intubation in the delivery room and cord/initial base-deficit ≥20 mmol/l. A scoring system was derived based on significant variables, and a score ≥5 had a 90% positive predictive value for abnormal outcome. Seizures, multiorgan failure and abnormal imaging studies were also significantly associated with abnormal outcome. Conclusions: The proposed scoring system, being highly predictive of outcome at 24 months' age, may be potentially useful in selecting subjects for preventive or therapeutic interventions to prevent or minimize neurologic morbidity due to hypoxic brain injury.
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U2 - 10.1038/sj.jp.7211259
DO - 10.1038/sj.jp.7211259
M3 - Article
C2 - 15703778
AN - SCOPUS:17144393308
SN - 0743-8346
VL - 25
SP - 245
EP - 250
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 4
ER -