Abstract
Extremely preterm infants have a high mortality and increased long term morbidity compared to babies born at term or later in gestation. They may have delays in motor, cognitive or developmental domains or persistent impairments. Frequently, in the NICU, investigations or evaluations are performed with the goal of trying to predict the long term outcomes for many different purposes. The characteristics of a test required for such predictions differ according to the different purposes. Individual prediction of profoundly abnormal outcome, based on any currently available test, is severely limited, and the use of any test in order to limit or redirect intensive care is difficult to justify, particularly because survivors of neonatal intensive care have almost universally good quality of life.
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References
Hack M, Taylor HG, Drotar D, Schluchter M, Cartar L, Wilson-Costello D, et al. Poor predictive validity of the Bayley scales of infant development for cognitive function of extremely low birth weight children at school age. Pediatrics. 2005;116(2):333–41.
Schmidt B, Anderson PJ, Doyle LW, Dewey D, Grunau RE, Asztalos EV, et al. Survival without disability to age 5 years after Neonatal Caffeine therapy for Apnea of prematurity. JAMA J Am Med Assoc. 2012;307(3):275–82.
Colombo J, Carlson SE. Is the measure the message: the bsid and nutritional interventions. Pediatrics. 2012.
Moore GP, Lemyre B, Barrowman N, Daboval T. Neurodevelopmental outcomes at 4 to 8 years of children born at 22 to 25 weeks’ gestational age: a meta-analysis. JAMA Pediatr. 2013.
Andrews B, Lagatta J, Chu A, Plesha-Troyke S, Schreiber M, Lantos J, et al. The nonimpact of gestational age on neurodevelopmental outcome for ventilated survivors born at 23–28 weeks of gestation. Acta Paediatr. 2012;101(6):574–8.
Moore T, Hennessy EM, Myles J, Johnson SJ, Draper ES, Costeloe KL, et al. Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies. BMJ. 2012;345:e7961.
Finer NN, Tarin T, Vaucher YE, Barrington K, Bejar R. Intact survival in extremely low birth weight infants after delivery room resuscitation. Pediatrics. 1999;104(4):e40.
Wyckoff MH, Salhab WA, Heyne RJ, Kendrick DE, Stoll BJ, LaptookAR. Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation. J Pediatr. 2012;160(2):239–44.e2.
Meadow W, Lagatta J, Andrews B, Lantos J. The mathematics of morality for neonatal resuscitation. Clin Perinatol. 2012;39(4):941–56.
Nongena P, Ederies A, Azzopardi DV, Edwards AD. Confidence in the prediction of neurodevelopmental outcome by cranial ultrasound and MRI in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2010;95(6):F388–F90.
Kuban K, Adler I, Allred E, Batton D, Bezinque S, Betz B, et al. Observer variability assessing US scans of the preterm brain: the ELGAN study. Pediatr Radiol. 2007;37(12):1201–8.
O’Shea TM, Kuban KC, Allred EN, Paneth N, Pagano M, Dammann O, et al. Neonatal cranial ultrasound lesions and developmental delays at 2 years of age among extremely low gestational age children. Pediatrics. 2008;122(3):e662–9.
Merhar SL, Tabangin ME, Meinzen-Derr J, Schibler KR. Grade and laterality of intraventricular haemorrhage to predict 18–22 month neurodevelopmental outcomes in extremely low birthweight infants. Acta Paediatr. 2012;101(4):414–8.
Broitman E, Ambalavanan N, Higgins RD, Vohr BR, Das A, Bhaskar B, et al. Clinical data predict neurodevelopmental outcome better than head ultrasound in extremely low birth weight infants. J Pediatr. 2007;151(5):500–5.e2.
Woodward LJ, Anderson PJ, Austin NC, Howard K, Inder TE. Neonatal MRI to predict neurodevelopmental outcomes in preterm infants. N Eng J Med. 2006;355(7):685–94.
Miller SP, Ferriero DM, Leonard C, Piecuch R, Glidden DV, Partridge JC, et al. Early brain injury in premature newborns detected with magnetic resonance imaging is associated with adverse early neurodevelopmental outcome. J Pediatr. 2005;147(5):609–16.
Mirmiran M, Barnes PD, Keller K, Constantinou JC, Fleisher BE, Hintz SR, et al. Neonatal brain magnetic resonance imaging before discharge is better than serial cranial ultrasound in predicting cerebral palsy in very low birth weight preterm infants. Pediatrics. 2004;114(4):992–8.
Pierrat V, Duquennoy C, van Haastert IC, Ernst M, Guilley N, de Vries LS. Ultrasound diagnosis and neurodevelopmental outcome of localised and extensive cystic periventricular leucomalacia. Arch Dis Child Fetal Neonatal Ed. 2001;84(3):F151–6.
Saigal S, Tyson J. Measurement of quality of life of survivors of neonatal intensive care: critique and implications. Semin Perinatol. 2008;32(1):59–66.
Payot A, Barrington KJ. The quality of life of young children and infants with chronic medical problems: review of the literature. Curr Probl Pediatr Adolesc Health Care. 2011;41(4):91–101.
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Barrington, K. (2016). Predicting Outcomes in the Very Preterm Infant. In: Verhagen, E., Janvier, A. (eds) Ethical Dilemmas for Critically Ill Babies. International Library of Ethics, Law, and the New Medicine, vol 65. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7360-7_7
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DOI: https://doi.org/10.1007/978-94-017-7360-7_7
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