complications of prematurity as risk factors for outcome

The increased rate of prematurity has been accompanied by high rates of neonatal complications and neurodevelopment sequels. Objective: The study was design to evaluate whether identifying certain complications of prematurity may be useful in predicting neurodevelopment outcome. Observational longitudinal study, over six years, of a cohort of premature infants. The risk factors quantified were: gestational age, birth weight, birth asphyxia, necessity of mechanical ventilation , specific pathology (respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia) ,results of Amiel –Tison, neurologic exam at discharge, total numbers of evaluations, final results of evaluations, acording to Bayley Scales of Infant Development, 2nd Edition at two years corrected age. The data were analyzed using SPSS Statistics version 18.0. From January 1, 2005 to December 31, 2011 the incidence of prematurity in our maternity was 13.65%. 33.03% (n=2182) were prematures and from these, 1845 were enrolled in this study. Complications of prematurity, developped by included patients were : respiratory distress syndrome (70.51%), apneea of prematurity (40.76%), perinatal asphyxia (22.82%), intraventricular hemorrhage (17.01%), periventricular leukomalacia (5.42%). Birth weight less than 1500g, type of mechanical ventilation , intraventricular hemorrhage, results of Amiel-Tison evaluations and adherence of patients to program are predictive factors for results of final evaluation. Gestational age remains the leading factor in including premature infants in a specific group of risk (F=69.65, p<<0.01, 95%CI). We speculate that early identification of the degree of risk may facilitate early interventions with the potential to improve the neurological outcome of these patients.