Outcome of Infants Born at 24-26 Weeks' Gestation: II. Neurodevelopmental Outcome.
PIECUCH, ROBERT E. MD; LEONARD, CAROL H. PhD; COOPER, BRUCE A. PhD; KILPATRICK, SARAH J. MD, PhD; SCHLUETER, MUREEN A.; SOLA, AUG USTO MD
Obstetrics & Gynecology.
90(5):809-814, November 1997.
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Objective: To assess the neurodevelopmental outcome of infants born at 24-26 weeks' gestation.
Methods: One hundred thirty-eight nonanomalous infants were born at our hospital after pregnancies of 24-26 weeks' gestation between 1990 and 1994. Ninety-four infants survived to discharge and 86 were followed in a nursery follow-up program for outcome. Associations between gestational age and neurodevelopmental outcome and risk factors and outcome were analyzed. Mean age at follow-up was 32 months.
Results: The frequency of cerebral palsy did not differ significantly in the three groups (11, 20, and 11% at 24, 25, and 26 weeks, respectively). The incidence of normal cognitive outcome was associated significantly with gestational age at birth (28, 47, and 71% normal at 24, 25, and 26 weeks, respectively). Poor neurologic outcome was associated with the medical risk factor of intracranial hemorrhage grade 3 or 4 or periventricular leukomalacia. Poor cognitive outcome was correlated with both medical and social risk factors; however, there was an association between poor cognitive outcome and lower gestational age (P <.05), regardless of the relationships of any other risk factors to cognitive outcome.
Conclusion: Although the incidence of cerebral palsy was low in these three groups, the high percentage of infants born at 24 and 25 weeks' gestation with cognitive deficits is concerning.
(C) 1997 The American College of Obstetricians and Gynecologists