Skip to main content
Log in

Obstetrical and neonatal risk factors in very low birth weight infants related to their neurological development

  • Original Investigations
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

An analysis of pre- and perinatal risks in very low birth weight (VLBW) infants showed that children later suffering from severe neurodevelopmental sequelae were exposed to a significantly higher number of risk factors compared to normally developed VLBW controls. This was not only due to a higher incidence of specific risks, but to the accumulation of risk factors, which consequently made an ischaemic or haemorrhagic brain lesion more likely to occur. This result suggests that brain lesions in VLBW infants are essentially multifactorial. The improved outcome of VLBW infants cared for in the NICU of the Children's Hospital of Tübingen during 1977–1983 was accompanied by a decreasing incidence of obstetrical and neonatal risks. This was mainly due to more frequent transport in utero, earlier obstetrical intervention, and immediate postnatal stabilization of the infant's condition. These changes in perinatal care strategy evidently favoured the postnatal course and thus also improved the neurodevelopmental outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

VLBW:

very low birth weight

NICU:

neonatal intensive care unit

ICH:

intracranial haemorrhage

IVH:

intraventricular haemorrhage

CSF:

cerebrospinal fluid

References

  1. Beverly DW, Chance GW, Inwood MJ, Schaus M, O'Keefe (1984) Intraventricular haemorrhage and haemostasis defects. Arch Dis Child 59:444–448

    Google Scholar 

  2. Clark CE, Clyman RI, Roth RS, Sniderman SH, Lane B, Ballard RA (1981) Risk factor analysis of intraventricular haemorrhage in low-birth-weight infants. J Pediatr 99:625–628

    Google Scholar 

  3. Friis-Hansen B (1985) Perinatal brain injury and cerebral blood flow in newborn infants. Acta Paediatr Scand 74:323–331

    Google Scholar 

  4. Fujimura M, Salisbury DM, Robinson RO, Howat P, Emerson PM, Keeling JW, Tizard JPM (1979) Clinical events relating to intraventricular haemorrhage in the newborn. Arch Dis Child 54:409–414

    Google Scholar 

  5. Haas G, Buchwald-Saal M, Leidig E, Mentzel H (1986) Improved outcome in very low birth weight infants from 1977 to 1983. Eur J Pediatr (in press)

  6. Largo RH, Wälli R, Duc G, Fanconi A, Prader A (1980) Evaluation of perinatal growth. Helv Paediatr Acta 35:419–436

    Google Scholar 

  7. Lou HC (1985) Perinatal hypoxic-ischaemic brain damage and periventricular haemorrhage. In: Harel S, Anastasiow NJ (eds) The at-risk-infant: Psycho/socio/medical aspects. Brookes, Baltimore London, pp 153–157

    Google Scholar 

  8. McDonald MM, Johnson ML, Rumack CM, Koops BL, Guggenheim MA, Babb C, Hathway WE (1984) Role of coagulopathy in newborn intracranial hemorrhage. Pediatrics 74:26–31

    Google Scholar 

  9. McDonald MM, Koops BL, Johnson ML, Guggenheim MA, Rumack CM, Mitchell SA, Hathaway WE (1984) Timing and antecedents of intracranial hemorrhage in the newborn. Pediatrics 74:32–36

    Google Scholar 

  10. Mentzel H (1984) Sectio bei Frühgeburt aus der Sicht des neonatologen. Indikation und Grenzen. Gynäkologe 17:243–249

    Google Scholar 

  11. Pape KE, Wigglesworth JS (1979) Haemorrhage, ischaemia and the perinatal brain. SIMP with Heinemann, London

    Google Scholar 

  12. Papiernick E, Bouyer M, Dreyfus J, Collin D, Winisdorffer G, Guegen S, Lecomte M, Lazar P (1985) Prevention of preterm births: A perinatal study in Haguenau, France. Pediatrics 76:154–158

    Google Scholar 

  13. Papile LA, Munsick-Bruno G, Schaefer A (1983) Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps. J Pediatr 103:273–277

    Google Scholar 

  14. Perlman JM, McMenamin JB, Volpe JJ (1983) Fluctuating cerebral blood flow velocity in respiratory-distress syndrome. Relation to the development of intraventricular hemorrhage. N Engl J Med 309:204–209

    Google Scholar 

  15. Prechtl HFR (1980) The optimality concept. Early Hum Dev 4:201–205

    Google Scholar 

  16. Stanley FJ, Atkinson S (1981) Impact of neonatal intensive care on cerebral palsy in infants of low birthweight. Lancet II:1162

    Google Scholar 

  17. Stewart AL, Thorburn RJ, Hope PL, Goldsmith M, Lipscomb AP, Reynolds EOR (1983) Ultrasound appearance of the brain in very preterm infants and neurodevelopmental outcome at 18 months of age. Arch Dis Child 58:598–604

    Google Scholar 

  18. Thompson MH, Khot AS (1985) Impact of neonatal intensive care. Arch Dis Child 60:213–214

    Google Scholar 

  19. Usher R, McLean F (1969) Intrauterine growth of live-born caucasian infants at sea level: Standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr 74:901–910

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Haas, G., Asprion, B., Leidig, E. et al. Obstetrical and neonatal risk factors in very low birth weight infants related to their neurological development. Eur J Pediatr 145, 341–346 (1986). https://doi.org/10.1007/BF00439235

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00439235

Key words

Navigation