Predictors of Mortality, Morbidity, and Disability in a Cohort of Infants ≤ 28 Weeks' Gestation

Michael E. Msall, Germaine M. Buck, Brian T. Rogers, Linda C. Duffy, Sharon R. Mallen, Nancy L. Catanzaro

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

This study attempted to identify predictors for mortality, morbidity, disability, and educational handicap at age 4 years in a cohort of 194 infants born at 23 to 28 weeks' gestation at one regionalized tertiary center from 1983 to 1986. Forty-one infants died (21%); standardized neurodevelopmental and functional assessments were conducted on 149 of 153 (97%) survivors at a mean age of 52 months. Five significant predictors of death were identified with logistic regression analysis: Gestational age 23 to 26 weeks, intraventricular hemorrhage grades 3 or 4, male gender, five-minute Apgar ≤3, and absence of prophylactic calf lung surfactant extract. Significant predictors of neurodevelopmental morbidity included sepsis, male gender, and nonwhite race. Significant predictors of disability at age four included neurodevelopmental impairment and severe retinopathy of prematurity. Low socioeconomic status, nonwhite race and male gender were predictive of educational handicap. These findings suggest that outcomes may have distinct pathophysiologies. The role of biomedical events appears strongest for death.

Original languageEnglish (US)
Pages (from-to)521-527
Number of pages7
JournalClinical pediatrics
Volume32
Issue number9
DOIs
StatePublished - Sep 1993

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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