Hypoxic/ischemic and infectious events have cumulative effects on the risk of cerebral palsy in very-low-birth-weight preterm infants

Lan Wan Wang, Yung Chieh Lin, Shan Tair Wang, Tsu Fu Yeh, Chao Ching Huang

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Hypoxia/ischemia and inflammation are two major mechanisms for cerebral palsy (CP) in preterm infants.

Objective: To investigate whether hypoxia/ischemia- And infection-related events in the perinatal and neonatal periods had cumulative effects on CP risk in very-low-birthweight (VLBW) premature infants.

Methods: From 1995 to 2005, 5,807 VLBW preterm infants admitted to Taiwan hospitals were enrolled. The cumulative effects of hypoxic/ischemic and infectious events during the perinatal and neonatal periods on CP risk at corrected age 24 months were analyzed.

Results: Of the 4,355 infants with 24-month follow-up, 457 (10.5%) had CP. The CP group had significantly higher incidences of hypoxia/ischemia-related events in the perinatal and neonatal periods, and sepsis in the neonatal period than the normal group. Three hypoxic/ischemic events, including birth cardiopulmonary resuscitation (OR 2.25; 95% CI 1.81-2.82), patent ductus arteriosus (PDA) ligation (2.94; 1.35-5.75) and chronic lung disease (3.14; 2.61-3.85) had the most significant contribution to CP. Relative to CP risk for infants with neither the three hypoxic/ischemic events nor sepsis, the CP odds increased 1.98-, 2.26- And 2.15-fold for infants with birth cardiopulmonary resuscitation, PDA ligation and chronic lung disease, respectively; while the combination with sepsis further increased the odds to 3.18-, 3.83- And 3.25-fold, respectively. Using the three hypoxic/ischemic events plus sepsis, CP rates were 10.0, 16.7, 26.7, 40.0 and 54.7% for infants with none, one, two, three and four events, respectively.

Conclusions: Hypoxic/ischemic and infectious events across the perinatal and neonatal periods exerted cumulative effects on CP risk in VLBW premature infants.

Original languageEnglish
Pages (from-to)209-215
Number of pages7
JournalNeonatology
Volume106
Issue number3
DOIs
Publication statusPublished - Nov 7 2014

Fingerprint

Very Low Birth Weight Infant
Cerebral Palsy
Premature Infants
Sepsis
Patent Ductus Arteriosus
Ischemia
Cardiopulmonary Resuscitation
Lung Diseases
Ligation
Chronic Disease
Parturition
Taiwan
Inflammation

Keywords

  • Cerebral palsy
  • Hypoxia/ischemia
  • Infection
  • Preterm infants
  • Very low birth weight

ASJC Scopus subject areas

  • Developmental Biology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Hypoxic/ischemic and infectious events have cumulative effects on the risk of cerebral palsy in very-low-birth-weight preterm infants. / Wang, Lan Wan; Lin, Yung Chieh; Wang, Shan Tair; Yeh, Tsu Fu; Huang, Chao Ching.

In: Neonatology, Vol. 106, No. 3, 07.11.2014, p. 209-215.

Research output: Contribution to journalArticle

Wang, Lan Wan ; Lin, Yung Chieh ; Wang, Shan Tair ; Yeh, Tsu Fu ; Huang, Chao Ching. / Hypoxic/ischemic and infectious events have cumulative effects on the risk of cerebral palsy in very-low-birth-weight preterm infants. In: Neonatology. 2014 ; Vol. 106, No. 3. pp. 209-215.
@article{aa51f7afd04a4952a1cff9ef4f18a0ea,
title = "Hypoxic/ischemic and infectious events have cumulative effects on the risk of cerebral palsy in very-low-birth-weight preterm infants",
abstract = "Background: Hypoxia/ischemia and inflammation are two major mechanisms for cerebral palsy (CP) in preterm infants.Objective: To investigate whether hypoxia/ischemia- And infection-related events in the perinatal and neonatal periods had cumulative effects on CP risk in very-low-birthweight (VLBW) premature infants.Methods: From 1995 to 2005, 5,807 VLBW preterm infants admitted to Taiwan hospitals were enrolled. The cumulative effects of hypoxic/ischemic and infectious events during the perinatal and neonatal periods on CP risk at corrected age 24 months were analyzed.Results: Of the 4,355 infants with 24-month follow-up, 457 (10.5{\%}) had CP. The CP group had significantly higher incidences of hypoxia/ischemia-related events in the perinatal and neonatal periods, and sepsis in the neonatal period than the normal group. Three hypoxic/ischemic events, including birth cardiopulmonary resuscitation (OR 2.25; 95{\%} CI 1.81-2.82), patent ductus arteriosus (PDA) ligation (2.94; 1.35-5.75) and chronic lung disease (3.14; 2.61-3.85) had the most significant contribution to CP. Relative to CP risk for infants with neither the three hypoxic/ischemic events nor sepsis, the CP odds increased 1.98-, 2.26- And 2.15-fold for infants with birth cardiopulmonary resuscitation, PDA ligation and chronic lung disease, respectively; while the combination with sepsis further increased the odds to 3.18-, 3.83- And 3.25-fold, respectively. Using the three hypoxic/ischemic events plus sepsis, CP rates were 10.0, 16.7, 26.7, 40.0 and 54.7{\%} for infants with none, one, two, three and four events, respectively.Conclusions: Hypoxic/ischemic and infectious events across the perinatal and neonatal periods exerted cumulative effects on CP risk in VLBW premature infants.",
keywords = "Cerebral palsy, Hypoxia/ischemia, Infection, Preterm infants, Very low birth weight",
author = "Wang, {Lan Wan} and Lin, {Yung Chieh} and Wang, {Shan Tair} and Yeh, {Tsu Fu} and Huang, {Chao Ching}",
year = "2014",
month = "11",
day = "7",
doi = "10.1159/000362782",
language = "English",
volume = "106",
pages = "209--215",
journal = "Neonatology",
issn = "1661-7800",
publisher = "S. Karger AG",
number = "3",

}

TY - JOUR

T1 - Hypoxic/ischemic and infectious events have cumulative effects on the risk of cerebral palsy in very-low-birth-weight preterm infants

AU - Wang, Lan Wan

AU - Lin, Yung Chieh

AU - Wang, Shan Tair

AU - Yeh, Tsu Fu

AU - Huang, Chao Ching

PY - 2014/11/7

Y1 - 2014/11/7

N2 - Background: Hypoxia/ischemia and inflammation are two major mechanisms for cerebral palsy (CP) in preterm infants.Objective: To investigate whether hypoxia/ischemia- And infection-related events in the perinatal and neonatal periods had cumulative effects on CP risk in very-low-birthweight (VLBW) premature infants.Methods: From 1995 to 2005, 5,807 VLBW preterm infants admitted to Taiwan hospitals were enrolled. The cumulative effects of hypoxic/ischemic and infectious events during the perinatal and neonatal periods on CP risk at corrected age 24 months were analyzed.Results: Of the 4,355 infants with 24-month follow-up, 457 (10.5%) had CP. The CP group had significantly higher incidences of hypoxia/ischemia-related events in the perinatal and neonatal periods, and sepsis in the neonatal period than the normal group. Three hypoxic/ischemic events, including birth cardiopulmonary resuscitation (OR 2.25; 95% CI 1.81-2.82), patent ductus arteriosus (PDA) ligation (2.94; 1.35-5.75) and chronic lung disease (3.14; 2.61-3.85) had the most significant contribution to CP. Relative to CP risk for infants with neither the three hypoxic/ischemic events nor sepsis, the CP odds increased 1.98-, 2.26- And 2.15-fold for infants with birth cardiopulmonary resuscitation, PDA ligation and chronic lung disease, respectively; while the combination with sepsis further increased the odds to 3.18-, 3.83- And 3.25-fold, respectively. Using the three hypoxic/ischemic events plus sepsis, CP rates were 10.0, 16.7, 26.7, 40.0 and 54.7% for infants with none, one, two, three and four events, respectively.Conclusions: Hypoxic/ischemic and infectious events across the perinatal and neonatal periods exerted cumulative effects on CP risk in VLBW premature infants.

AB - Background: Hypoxia/ischemia and inflammation are two major mechanisms for cerebral palsy (CP) in preterm infants.Objective: To investigate whether hypoxia/ischemia- And infection-related events in the perinatal and neonatal periods had cumulative effects on CP risk in very-low-birthweight (VLBW) premature infants.Methods: From 1995 to 2005, 5,807 VLBW preterm infants admitted to Taiwan hospitals were enrolled. The cumulative effects of hypoxic/ischemic and infectious events during the perinatal and neonatal periods on CP risk at corrected age 24 months were analyzed.Results: Of the 4,355 infants with 24-month follow-up, 457 (10.5%) had CP. The CP group had significantly higher incidences of hypoxia/ischemia-related events in the perinatal and neonatal periods, and sepsis in the neonatal period than the normal group. Three hypoxic/ischemic events, including birth cardiopulmonary resuscitation (OR 2.25; 95% CI 1.81-2.82), patent ductus arteriosus (PDA) ligation (2.94; 1.35-5.75) and chronic lung disease (3.14; 2.61-3.85) had the most significant contribution to CP. Relative to CP risk for infants with neither the three hypoxic/ischemic events nor sepsis, the CP odds increased 1.98-, 2.26- And 2.15-fold for infants with birth cardiopulmonary resuscitation, PDA ligation and chronic lung disease, respectively; while the combination with sepsis further increased the odds to 3.18-, 3.83- And 3.25-fold, respectively. Using the three hypoxic/ischemic events plus sepsis, CP rates were 10.0, 16.7, 26.7, 40.0 and 54.7% for infants with none, one, two, three and four events, respectively.Conclusions: Hypoxic/ischemic and infectious events across the perinatal and neonatal periods exerted cumulative effects on CP risk in VLBW premature infants.

KW - Cerebral palsy

KW - Hypoxia/ischemia

KW - Infection

KW - Preterm infants

KW - Very low birth weight

UR - http://www.scopus.com/inward/record.url?scp=84903858171&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84903858171&partnerID=8YFLogxK

U2 - 10.1159/000362782

DO - 10.1159/000362782

M3 - Article

C2 - 25012626

AN - SCOPUS:84903858171

VL - 106

SP - 209

EP - 215

JO - Neonatology

JF - Neonatology

SN - 1661-7800

IS - 3

ER -