Neurodevelopmental outcome of extremely low birth weight infants with posthemorrhagic hydrocephalus requiring shunt insertion
Ira Adams-Chapman, Nellie I Hansen, Barbara J Stoll, Rose Higgins, NICHD Research Network, Alan Jobe, William Oh, Betty R Vohr, Angelita Hensman, Lucy Noel, Avroy A Fanaroff, Michele C Walsh, Deanne Wilson-Costello, Nancy S Newman, Bonnie S Siner, Ronald N Goldberg, Ricki Goldstein, Kathy Auten, Melody Lohmeyer, Barbara J Stoll, Ira Adams-Chapman, Ellen Hale, Ann R Stark, Kimberly Gronsman Lee, Kerri Fournier, Colleen Driscoll, Brenda B Poindexter, Anna M Dusick, Diana D Appel, Dianne Herron, Lucy Miller, Leslie Dawn Wilson, Leslie Richard, Linda L Wright, Elizabeth M McClure, W Kenneth Poole, Betty Hastings, David K Stevenson, Susan R Hintz, Barry E Fleisher, Joan M Baran, M Bethany Ball, Waldemar A Carlo, Namasivayam Ambalavanan, Myriam Peralta-Carcelen, Monica V Collins, Shirley S Cosby, Vivien Phillips, Neil N Finer, David Kaegi, Yvonne E Vaucher, Maynard R Rasmussen, Kathy Arnell, Clarence Demetrio, Martha G Fuller, Chris Henderson, Edward F Donovan, Jean Steichen, Barb Alexander, Cathy Grisby, Marcia Mersmann, Holly Mincey, Jody Shively, Teresa L Gratton, Charles R Bauer, Shahnaz Duara, Ruth Everett, Lu-Ann Papile, Conra Backstrom Lacy, Dale L Phelps, Gary Myers, Linda Reubens, Diane Hust, Gina Rowan, Sheldon B Korones, Henrietta S Bada, Tina Hudson, Kim Yolton, Marilyn Williams, Abbot R Laptook, Walid A Salhab, R Sue Broyles, Gay Hensley, Jackie F Hickman, Susie Madison, Nancy A Miller, Jon E Tyson, Brenda H Morris, Pamela J Bradt, Esther G Akpa, Patty A Cluff, Claudia Y Franco, Anna E Lis, Georgia McDavid, T Michael O'Shea, Robert Dillard, Nancy Peters, Barbara Jackson, Seetha Shankaran, Yvette Johnson, Rebecca Bara, Debbie Kennedy, Geraldine Muran, Richard A Ehrenkranz, Linda Mayes, Patricia Gettner, Monica Konstantino, Elaine Romano, Ira Adams-Chapman, Nellie I Hansen, Barbara J Stoll, Rose Higgins, NICHD Research Network, Alan Jobe, William Oh, Betty R Vohr, Angelita Hensman, Lucy Noel, Avroy A Fanaroff, Michele C Walsh, Deanne Wilson-Costello, Nancy S Newman, Bonnie S Siner, Ronald N Goldberg, Ricki Goldstein, Kathy Auten, Melody Lohmeyer, Barbara J Stoll, Ira Adams-Chapman, Ellen Hale, Ann R Stark, Kimberly Gronsman Lee, Kerri Fournier, Colleen Driscoll, Brenda B Poindexter, Anna M Dusick, Diana D Appel, Dianne Herron, Lucy Miller, Leslie Dawn Wilson, Leslie Richard, Linda L Wright, Elizabeth M McClure, W Kenneth Poole, Betty Hastings, David K Stevenson, Susan R Hintz, Barry E Fleisher, Joan M Baran, M Bethany Ball, Waldemar A Carlo, Namasivayam Ambalavanan, Myriam Peralta-Carcelen, Monica V Collins, Shirley S Cosby, Vivien Phillips, Neil N Finer, David Kaegi, Yvonne E Vaucher, Maynard R Rasmussen, Kathy Arnell, Clarence Demetrio, Martha G Fuller, Chris Henderson, Edward F Donovan, Jean Steichen, Barb Alexander, Cathy Grisby, Marcia Mersmann, Holly Mincey, Jody Shively, Teresa L Gratton, Charles R Bauer, Shahnaz Duara, Ruth Everett, Lu-Ann Papile, Conra Backstrom Lacy, Dale L Phelps, Gary Myers, Linda Reubens, Diane Hust, Gina Rowan, Sheldon B Korones, Henrietta S Bada, Tina Hudson, Kim Yolton, Marilyn Williams, Abbot R Laptook, Walid A Salhab, R Sue Broyles, Gay Hensley, Jackie F Hickman, Susie Madison, Nancy A Miller, Jon E Tyson, Brenda H Morris, Pamela J Bradt, Esther G Akpa, Patty A Cluff, Claudia Y Franco, Anna E Lis, Georgia McDavid, T Michael O'Shea, Robert Dillard, Nancy Peters, Barbara Jackson, Seetha Shankaran, Yvette Johnson, Rebecca Bara, Debbie Kennedy, Geraldine Muran, Richard A Ehrenkranz, Linda Mayes, Patricia Gettner, Monica Konstantino, Elaine Romano
Abstract
Objective: We aimed to evaluate neurodevelopmental and growth outcomes among extremely low birth weight infants who had severe intraventricular hemorrhage that required shunt insertion compared with infants without shunt insertion.
Methods: Infants who were born in 1993-2002 with birth weights of 401 to 1000 g were enrolled in a very low birth weight registry at medical centers that participate in the National Institute of Child Health and Human Development Neonatal Research Network, and returned for follow-up at 18 to 22 months' corrected age were studied. Eighty-two percent of survivors completed follow-up, and 6161 children were classified into 5 groups: group 1, no intraventricular hemorrhage/no shunt (n = 5163); group 2, intraventricular hemorrhage grade 3/no shunt (n = 459); group 3, intraventricular hemorrhage grade 3/shunt (n = 103); group 4, intraventricular hemorrhage grade 4/no shunt (n = 311); and group 5, intraventricular hemorrhage grade 4/shunt (n = 125). Group comparisons were evaluated with chi(2) and Wilcoxon tests, and regression models were used to compare outcomes after adjustment for covariates.
Results: Children with severe intraventricular hemorrhage and shunts had significantly lower scores on the Bayley Scales of Infant Development IIR compared with children with no intraventricular hemorrhage and with children with intraventricular hemorrhage of the same grade and no shunt. Infants with shunts were at increased risk for cerebral palsy and head circumference at the <10th percentile at 18 months' adjusted age. Greatest differences were observed between children with shunts and those with no intraventricular hemorrhage on these outcomes.
Conclusions: This large cohort study suggests that extremely low birth weight children with severe intraventricular hemorrhage that requires shunt insertion are at greatest risk for adverse neurodevelopmental and growth outcomes at 18 to 22 months compared with children with and without severe intraventricular hemorrhage and with no shunt. Long-term follow-up is needed to determine whether adverse outcomes persist or improve over time.
Source: PubMed