Death or Neurodevelopmental Impairment at 18 to 22 Months Corrected Age in a Randomized Trial of Early Dexamethasone to Prevent Death or Chronic Lung Disease in Extremely Low Birth Weight Infants
Objective To evaluate the incidence of death or neurodevelopmental impairment (NDI) at 18-22 months corrected age in subjects enrolled in a trial of early dexamethasone treatment to prevent death or chronic lung disease in extremely low birth weight infants. Study design Evaluation of infants at 18-...
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| creator | Stark, Ann R., MD Carlo, Waldemar A., MD Vohr, Betty R., MD Papile, Lu Ann, MD Saha, Shampa, PhD Bauer, Charles R., MD Oh, William, MD Shankaran, Seetha, MD Tyson, Jon E., MD, MPH Wright, Linda L., MD Poole, W. Kenneth, PhD Das, Abhik, PhD Stoll, Barbara J., MD Fanaroff, Avroy A., MD Korones, Sheldon B., MD Ehrenkranz, Richard A., MD Stevenson, David K., MD Peralta-Carcelen, Myriam, MD, MPH Wilson-Costello, Deanne E., MD Bada, Henrietta S., MD Heyne, Roy J., MD Johnson, Yvette R., MD, MPH Lee, Kimberly Gronsman, MD Steichen, Jean J., MD |
| description | Objective To evaluate the incidence of death or neurodevelopmental impairment (NDI) at 18-22 months corrected age in subjects enrolled in a trial of early dexamethasone treatment to prevent death or chronic lung disease in extremely low birth weight infants. Study design Evaluation of infants at 18-22 months corrected age included anthropomorphic measurements, a standard neurological examination, and the Bayley Scales of Infant Development-II, including the Mental Developmental Index and the Psychomotor Developmental Index. NDI was defined as moderate or severe cerebral palsy, Mental Developmental Index or Psychomotor Developmental Index |
| doi_str_mv | 10.1016/j.jpeds.2013.07.027 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1490733404</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022347613009359</els_id><sourcerecordid>1490733404</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-ff90bc7fc64299c3420f9f2fe01aa5908e14fc073d2677519ba358d186044ea03</originalsourceid><addsrcrecordid>eNqFUsuO0zAUjRCIKQNfgIS8ZNNybadJvQBpaAtUKg_BIJaW61y3LoldbGeY8nv8GM50mAUbVpat85DPOUXxlMKEAq1e7Cf7AzZxwoDyCdQTYPW9YkRB1ONqxvn9YgTA2JiXdXVWPIpxDwCiBHhYnDEuBKtqPip-L1ClHfGBfMA--AavsPWHDl1SLVl1B2XDcCEqETojyRPGyHvv0i6SuQ8BdcKGXGyRWEcU-axc4zv7K79dBpsVvCFLFdojWeC16jDtVPQOB51PIVtl4Tv_-S54ZzVZ925LFjaiijeqy-sUsMOssfY_yWsbMvwb2u0ukZUzyqX4uHhgVBvxye15Xnx9s7ycvxuvP75dzS_WY11ORRobI2Cja6OrkgmhecnACMMMAlVqKmCGtDQaat7kaOopFRvFp7OGziooS1TAz4vnJ91D8D96jEl2NmpsW-XQ91HSUmQ2L6HMUH6C6uBjDGjkIdhOhaOkIIf25F7etCeH9iTUMreXWc9uDfpNh80d529dGfDyBMD8zSuLQUZt0Wls7FCFbLz9j8Grf_i6tTl01X7HI8a974PLCUoqI5MgvwwDGvZDeZ4Onwr-B_MVwoE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1490733404</pqid></control><display><type>article</type><title>Death or Neurodevelopmental Impairment at 18 to 22 Months Corrected Age in a Randomized Trial of Early Dexamethasone to Prevent Death or Chronic Lung Disease in Extremely Low Birth Weight Infants</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Stark, Ann R., MD ; Carlo, Waldemar A., MD ; Vohr, Betty R., MD ; Papile, Lu Ann, MD ; Saha, Shampa, PhD ; Bauer, Charles R., MD ; Oh, William, MD ; Shankaran, Seetha, MD ; Tyson, Jon E., MD, MPH ; Wright, Linda L., MD ; Poole, W. Kenneth, PhD ; Das, Abhik, PhD ; Stoll, Barbara J., MD ; Fanaroff, Avroy A., MD ; Korones, Sheldon B., MD ; Ehrenkranz, Richard A., MD ; Stevenson, David K., MD ; Peralta-Carcelen, Myriam, MD, MPH ; Wilson-Costello, Deanne E., MD ; Bada, Henrietta S., MD ; Heyne, Roy J., MD ; Johnson, Yvette R., MD, MPH ; Lee, Kimberly Gronsman, MD ; Steichen, Jean J., MD</creator><creatorcontrib>Stark, Ann R., MD ; Carlo, Waldemar A., MD ; Vohr, Betty R., MD ; Papile, Lu Ann, MD ; Saha, Shampa, PhD ; Bauer, Charles R., MD ; Oh, William, MD ; Shankaran, Seetha, MD ; Tyson, Jon E., MD, MPH ; Wright, Linda L., MD ; Poole, W. Kenneth, PhD ; Das, Abhik, PhD ; Stoll, Barbara J., MD ; Fanaroff, Avroy A., MD ; Korones, Sheldon B., MD ; Ehrenkranz, Richard A., MD ; Stevenson, David K., MD ; Peralta-Carcelen, Myriam, MD, MPH ; Wilson-Costello, Deanne E., MD ; Bada, Henrietta S., MD ; Heyne, Roy J., MD ; Johnson, Yvette R., MD, MPH ; Lee, Kimberly Gronsman, MD ; Steichen, Jean J., MD ; National Institute of Child Health and Human Development Neonatal Research Network ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network</creatorcontrib><description>Objective To evaluate the incidence of death or neurodevelopmental impairment (NDI) at 18-22 months corrected age in subjects enrolled in a trial of early dexamethasone treatment to prevent death or chronic lung disease in extremely low birth weight infants. Study design Evaluation of infants at 18-22 months corrected age included anthropomorphic measurements, a standard neurological examination, and the Bayley Scales of Infant Development-II, including the Mental Developmental Index and the Psychomotor Developmental Index. NDI was defined as moderate or severe cerebral palsy, Mental Developmental Index or Psychomotor Developmental Index <70, blindness, or hearing impairment. Results Death or NDI at 18-22 months corrected age was similar in the dexamethasone and placebo groups (65% vs 66%, P = .99 among those with known outcome). The proportion of survivors with NDI was also similar, as were mean values for weight, length, and head circumference and the proportion of infants with poor growth (50% vs 41%, P = .42 for weight less than 10th percentile); 49% of infants in the placebo group received treatment with corticosteroid compared with 32% in the dexamethasone group ( P = .02). Conclusion The risk of death or NDI and rate of poor growth were high but similar in the dexamethasone and placebo groups. The lack of a discernible effect of early dexamethasone on neurodevelopmental outcome may be due to frequent clinical corticosteroid use in the placebo group.</description><identifier>ISSN: 0022-3476</identifier><identifier>ISSN: 1097-6833</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2013.07.027</identifier><identifier>PMID: 23992673</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Cause of Death - trends ; Child Development ; Chronic Disease ; Developmental Disabilities - epidemiology ; Developmental Disabilities - etiology ; Developmental Disabilities - prevention & control ; Dexamethasone - administration & dosage ; Dose-Response Relationship, Drug ; Double-Blind Method ; Follow-Up Studies ; Glucocorticoids - administration & dosage ; Humans ; Incidence ; Infant ; Infant, Extremely Low Birth Weight ; Injections, Intravenous ; Lung Diseases - complications ; Lung Diseases - epidemiology ; Lung Diseases - prevention & control ; Neurologic Examination ; Pediatrics ; Retrospective Studies ; Survival Rate - trends ; Time Factors ; Treatment Outcome ; United States - epidemiology</subject><ispartof>The Journal of pediatrics, 2014, Vol.164 (1), p.34-39.e2</ispartof><rights>Mosby, Inc.</rights><rights>2014 Mosby, Inc.</rights><rights>Copyright © 2014 Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-ff90bc7fc64299c3420f9f2fe01aa5908e14fc073d2677519ba358d186044ea03</citedby><cites>FETCH-LOGICAL-c459t-ff90bc7fc64299c3420f9f2fe01aa5908e14fc073d2677519ba358d186044ea03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022347613009359$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23992673$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stark, Ann R., MD</creatorcontrib><creatorcontrib>Carlo, Waldemar A., MD</creatorcontrib><creatorcontrib>Vohr, Betty R., MD</creatorcontrib><creatorcontrib>Papile, Lu Ann, MD</creatorcontrib><creatorcontrib>Saha, Shampa, PhD</creatorcontrib><creatorcontrib>Bauer, Charles R., MD</creatorcontrib><creatorcontrib>Oh, William, MD</creatorcontrib><creatorcontrib>Shankaran, Seetha, MD</creatorcontrib><creatorcontrib>Tyson, Jon E., MD, MPH</creatorcontrib><creatorcontrib>Wright, Linda L., MD</creatorcontrib><creatorcontrib>Poole, W. Kenneth, PhD</creatorcontrib><creatorcontrib>Das, Abhik, PhD</creatorcontrib><creatorcontrib>Stoll, Barbara J., MD</creatorcontrib><creatorcontrib>Fanaroff, Avroy A., MD</creatorcontrib><creatorcontrib>Korones, Sheldon B., MD</creatorcontrib><creatorcontrib>Ehrenkranz, Richard A., MD</creatorcontrib><creatorcontrib>Stevenson, David K., MD</creatorcontrib><creatorcontrib>Peralta-Carcelen, Myriam, MD, MPH</creatorcontrib><creatorcontrib>Wilson-Costello, Deanne E., MD</creatorcontrib><creatorcontrib>Bada, Henrietta S., MD</creatorcontrib><creatorcontrib>Heyne, Roy J., MD</creatorcontrib><creatorcontrib>Johnson, Yvette R., MD, MPH</creatorcontrib><creatorcontrib>Lee, Kimberly Gronsman, MD</creatorcontrib><creatorcontrib>Steichen, Jean J., MD</creatorcontrib><creatorcontrib>National Institute of Child Health and Human Development Neonatal Research Network</creatorcontrib><creatorcontrib>Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network</creatorcontrib><title>Death or Neurodevelopmental Impairment at 18 to 22 Months Corrected Age in a Randomized Trial of Early Dexamethasone to Prevent Death or Chronic Lung Disease in Extremely Low Birth Weight Infants</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>Objective To evaluate the incidence of death or neurodevelopmental impairment (NDI) at 18-22 months corrected age in subjects enrolled in a trial of early dexamethasone treatment to prevent death or chronic lung disease in extremely low birth weight infants. Study design Evaluation of infants at 18-22 months corrected age included anthropomorphic measurements, a standard neurological examination, and the Bayley Scales of Infant Development-II, including the Mental Developmental Index and the Psychomotor Developmental Index. NDI was defined as moderate or severe cerebral palsy, Mental Developmental Index or Psychomotor Developmental Index <70, blindness, or hearing impairment. Results Death or NDI at 18-22 months corrected age was similar in the dexamethasone and placebo groups (65% vs 66%, P = .99 among those with known outcome). The proportion of survivors with NDI was also similar, as were mean values for weight, length, and head circumference and the proportion of infants with poor growth (50% vs 41%, P = .42 for weight less than 10th percentile); 49% of infants in the placebo group received treatment with corticosteroid compared with 32% in the dexamethasone group ( P = .02). Conclusion The risk of death or NDI and rate of poor growth were high but similar in the dexamethasone and placebo groups. The lack of a discernible effect of early dexamethasone on neurodevelopmental outcome may be due to frequent clinical corticosteroid use in the placebo group.</description><subject>Cause of Death - trends</subject><subject>Child Development</subject><subject>Chronic Disease</subject><subject>Developmental Disabilities - epidemiology</subject><subject>Developmental Disabilities - etiology</subject><subject>Developmental Disabilities - prevention & control</subject><subject>Dexamethasone - administration & dosage</subject><subject>Dose-Response Relationship, Drug</subject><subject>Double-Blind Method</subject><subject>Follow-Up Studies</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Extremely Low Birth Weight</subject><subject>Injections, Intravenous</subject><subject>Lung Diseases - complications</subject><subject>Lung Diseases - epidemiology</subject><subject>Lung Diseases - prevention & control</subject><subject>Neurologic Examination</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><issn>0022-3476</issn><issn>1097-6833</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUsuO0zAUjRCIKQNfgIS8ZNNybadJvQBpaAtUKg_BIJaW61y3LoldbGeY8nv8GM50mAUbVpat85DPOUXxlMKEAq1e7Cf7AzZxwoDyCdQTYPW9YkRB1ONqxvn9YgTA2JiXdXVWPIpxDwCiBHhYnDEuBKtqPip-L1ClHfGBfMA--AavsPWHDl1SLVl1B2XDcCEqETojyRPGyHvv0i6SuQ8BdcKGXGyRWEcU-axc4zv7K79dBpsVvCFLFdojWeC16jDtVPQOB51PIVtl4Tv_-S54ZzVZ925LFjaiijeqy-sUsMOssfY_yWsbMvwb2u0ukZUzyqX4uHhgVBvxye15Xnx9s7ycvxuvP75dzS_WY11ORRobI2Cja6OrkgmhecnACMMMAlVqKmCGtDQaat7kaOopFRvFp7OGziooS1TAz4vnJ91D8D96jEl2NmpsW-XQ91HSUmQ2L6HMUH6C6uBjDGjkIdhOhaOkIIf25F7etCeH9iTUMreXWc9uDfpNh80d529dGfDyBMD8zSuLQUZt0Wls7FCFbLz9j8Grf_i6tTl01X7HI8a974PLCUoqI5MgvwwDGvZDeZ4Onwr-B_MVwoE</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Stark, Ann R., MD</creator><creator>Carlo, Waldemar A., MD</creator><creator>Vohr, Betty R., MD</creator><creator>Papile, Lu Ann, MD</creator><creator>Saha, Shampa, PhD</creator><creator>Bauer, Charles R., MD</creator><creator>Oh, William, MD</creator><creator>Shankaran, Seetha, MD</creator><creator>Tyson, Jon E., MD, MPH</creator><creator>Wright, Linda L., MD</creator><creator>Poole, W. Kenneth, PhD</creator><creator>Das, Abhik, PhD</creator><creator>Stoll, Barbara J., MD</creator><creator>Fanaroff, Avroy A., MD</creator><creator>Korones, Sheldon B., MD</creator><creator>Ehrenkranz, Richard A., MD</creator><creator>Stevenson, David K., MD</creator><creator>Peralta-Carcelen, Myriam, MD, MPH</creator><creator>Wilson-Costello, Deanne E., MD</creator><creator>Bada, Henrietta S., MD</creator><creator>Heyne, Roy J., MD</creator><creator>Johnson, Yvette R., MD, MPH</creator><creator>Lee, Kimberly Gronsman, MD</creator><creator>Steichen, Jean J., MD</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2014</creationdate><title>Death or Neurodevelopmental Impairment at 18 to 22 Months Corrected Age in a Randomized Trial of Early Dexamethasone to Prevent Death or Chronic Lung Disease in Extremely Low Birth Weight Infants</title><author>Stark, Ann R., MD ; Carlo, Waldemar A., MD ; Vohr, Betty R., MD ; Papile, Lu Ann, MD ; Saha, Shampa, PhD ; Bauer, Charles R., MD ; Oh, William, MD ; Shankaran, Seetha, MD ; Tyson, Jon E., MD, MPH ; Wright, Linda L., MD ; Poole, W. Kenneth, PhD ; Das, Abhik, PhD ; Stoll, Barbara J., MD ; Fanaroff, Avroy A., MD ; Korones, Sheldon B., MD ; Ehrenkranz, Richard A., MD ; Stevenson, David K., MD ; Peralta-Carcelen, Myriam, MD, MPH ; Wilson-Costello, Deanne E., MD ; Bada, Henrietta S., MD ; Heyne, Roy J., MD ; Johnson, Yvette R., MD, MPH ; Lee, Kimberly Gronsman, MD ; Steichen, Jean J., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-ff90bc7fc64299c3420f9f2fe01aa5908e14fc073d2677519ba358d186044ea03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Cause of Death - trends</topic><topic>Child Development</topic><topic>Chronic Disease</topic><topic>Developmental Disabilities - epidemiology</topic><topic>Developmental Disabilities - etiology</topic><topic>Developmental Disabilities - prevention & control</topic><topic>Dexamethasone - administration & dosage</topic><topic>Dose-Response Relationship, Drug</topic><topic>Double-Blind Method</topic><topic>Follow-Up Studies</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Extremely Low Birth Weight</topic><topic>Injections, Intravenous</topic><topic>Lung Diseases - complications</topic><topic>Lung Diseases - epidemiology</topic><topic>Lung Diseases - prevention & control</topic><topic>Neurologic Examination</topic><topic>Pediatrics</topic><topic>Retrospective Studies</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stark, Ann R., MD</creatorcontrib><creatorcontrib>Carlo, Waldemar A., MD</creatorcontrib><creatorcontrib>Vohr, Betty R., MD</creatorcontrib><creatorcontrib>Papile, Lu Ann, MD</creatorcontrib><creatorcontrib>Saha, Shampa, PhD</creatorcontrib><creatorcontrib>Bauer, Charles R., MD</creatorcontrib><creatorcontrib>Oh, William, MD</creatorcontrib><creatorcontrib>Shankaran, Seetha, MD</creatorcontrib><creatorcontrib>Tyson, Jon E., MD, MPH</creatorcontrib><creatorcontrib>Wright, Linda L., MD</creatorcontrib><creatorcontrib>Poole, W. Kenneth, PhD</creatorcontrib><creatorcontrib>Das, Abhik, PhD</creatorcontrib><creatorcontrib>Stoll, Barbara J., MD</creatorcontrib><creatorcontrib>Fanaroff, Avroy A., MD</creatorcontrib><creatorcontrib>Korones, Sheldon B., MD</creatorcontrib><creatorcontrib>Ehrenkranz, Richard A., MD</creatorcontrib><creatorcontrib>Stevenson, David K., MD</creatorcontrib><creatorcontrib>Peralta-Carcelen, Myriam, MD, MPH</creatorcontrib><creatorcontrib>Wilson-Costello, Deanne E., MD</creatorcontrib><creatorcontrib>Bada, Henrietta S., MD</creatorcontrib><creatorcontrib>Heyne, Roy J., MD</creatorcontrib><creatorcontrib>Johnson, Yvette R., MD, MPH</creatorcontrib><creatorcontrib>Lee, Kimberly Gronsman, MD</creatorcontrib><creatorcontrib>Steichen, Jean J., MD</creatorcontrib><creatorcontrib>National Institute of Child Health and Human Development Neonatal Research Network</creatorcontrib><creatorcontrib>Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stark, Ann R., MD</au><au>Carlo, Waldemar A., MD</au><au>Vohr, Betty R., MD</au><au>Papile, Lu Ann, MD</au><au>Saha, Shampa, PhD</au><au>Bauer, Charles R., MD</au><au>Oh, William, MD</au><au>Shankaran, Seetha, MD</au><au>Tyson, Jon E., MD, MPH</au><au>Wright, Linda L., MD</au><au>Poole, W. Kenneth, PhD</au><au>Das, Abhik, PhD</au><au>Stoll, Barbara J., MD</au><au>Fanaroff, Avroy A., MD</au><au>Korones, Sheldon B., MD</au><au>Ehrenkranz, Richard A., MD</au><au>Stevenson, David K., MD</au><au>Peralta-Carcelen, Myriam, MD, MPH</au><au>Wilson-Costello, Deanne E., MD</au><au>Bada, Henrietta S., MD</au><au>Heyne, Roy J., MD</au><au>Johnson, Yvette R., MD, MPH</au><au>Lee, Kimberly Gronsman, MD</au><au>Steichen, Jean J., MD</au><aucorp>National Institute of Child Health and Human Development Neonatal Research Network</aucorp><aucorp>Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Death or Neurodevelopmental Impairment at 18 to 22 Months Corrected Age in a Randomized Trial of Early Dexamethasone to Prevent Death or Chronic Lung Disease in Extremely Low Birth Weight Infants</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2014</date><risdate>2014</risdate><volume>164</volume><issue>1</issue><spage>34</spage><epage>39.e2</epage><pages>34-39.e2</pages><issn>0022-3476</issn><issn>1097-6833</issn><eissn>1097-6833</eissn><abstract>Objective To evaluate the incidence of death or neurodevelopmental impairment (NDI) at 18-22 months corrected age in subjects enrolled in a trial of early dexamethasone treatment to prevent death or chronic lung disease in extremely low birth weight infants. Study design Evaluation of infants at 18-22 months corrected age included anthropomorphic measurements, a standard neurological examination, and the Bayley Scales of Infant Development-II, including the Mental Developmental Index and the Psychomotor Developmental Index. NDI was defined as moderate or severe cerebral palsy, Mental Developmental Index or Psychomotor Developmental Index <70, blindness, or hearing impairment. Results Death or NDI at 18-22 months corrected age was similar in the dexamethasone and placebo groups (65% vs 66%, P = .99 among those with known outcome). The proportion of survivors with NDI was also similar, as were mean values for weight, length, and head circumference and the proportion of infants with poor growth (50% vs 41%, P = .42 for weight less than 10th percentile); 49% of infants in the placebo group received treatment with corticosteroid compared with 32% in the dexamethasone group ( P = .02). Conclusion The risk of death or NDI and rate of poor growth were high but similar in the dexamethasone and placebo groups. The lack of a discernible effect of early dexamethasone on neurodevelopmental outcome may be due to frequent clinical corticosteroid use in the placebo group.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>23992673</pmid><doi>10.1016/j.jpeds.2013.07.027</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | The Journal of pediatrics, 2014, Vol.164 (1), p.34-39.e2 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Cause of Death - trends Child Development Chronic Disease Developmental Disabilities - epidemiology Developmental Disabilities - etiology Developmental Disabilities - prevention & control Dexamethasone - administration & dosage Dose-Response Relationship, Drug Double-Blind Method Follow-Up Studies Glucocorticoids - administration & dosage Humans Incidence Infant Infant, Extremely Low Birth Weight Injections, Intravenous Lung Diseases - complications Lung Diseases - epidemiology Lung Diseases - prevention & control Neurologic Examination Pediatrics Retrospective Studies Survival Rate - trends Time Factors Treatment Outcome United States - epidemiology |
| title | Death or Neurodevelopmental Impairment at 18 to 22 Months Corrected Age in a Randomized Trial of Early Dexamethasone to Prevent Death or Chronic Lung Disease in Extremely Low Birth Weight Infants |
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