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Antenatal steriods may reduce adverse neurological outcome follow chorioamnionitis: Neurodevelopmental outcome and chorioamnionitis in premature infants

Kent, Alison; Lomas, Fred; Hurrion, Elizabeth; Dahlstrom, Jane

Description

Objective; To examine the effect of antenatal steroid exposure and in utero inflammation on the development of severe intraventricular haemorrhage, periventricular leukomalacia and long-term neurological outcome in infants less than 30 completed weeks gestation. Method: Infants less than 30 completed weeks gestation from January 1996 to July 2001 were identified from a prospectively managed database. Placental pathology was reviewed for the presence or absence of chorioamnionitis and funisitis....[Show more]

dc.contributor.authorKent, Alison
dc.contributor.authorLomas, Fred
dc.contributor.authorHurrion, Elizabeth
dc.contributor.authorDahlstrom, Jane
dc.date.accessioned2015-12-13T22:53:31Z
dc.identifier.issn1034-4810
dc.identifier.urihttp://hdl.handle.net/1885/81845
dc.description.abstractObjective; To examine the effect of antenatal steroid exposure and in utero inflammation on the development of severe intraventricular haemorrhage, periventricular leukomalacia and long-term neurological outcome in infants less than 30 completed weeks gestation. Method: Infants less than 30 completed weeks gestation from January 1996 to July 2001 were identified from a prospectively managed database. Placental pathology was reviewed for the presence or absence of chorioamnionitis and funisitis. Infants were divided into three groups depending on the degree of exposure to fetal inflammation (no inflammation, chorioamnionitis only and chorioamnionitis and funisitis). Data relating to gestational age, birthweight, sex, antenatal steroid exposure, surfactant treatment, days of positive pressure ventilation and days of oxygen requirement were collected. Cerebral ultrasound studies were examined for evidence of intraventricular or intraparenchymal echodensity and periventricular leukomalacia. Long-term neurological outcome was assessed by neurological examination for cerebral palsy and by Griffiths Mental Developmental Assessment for general developmental quotient. Results: Two hundred and twenty infants were identified. The mean gestational age was 27.7 weeks and the mean birthweight 1092 g, Seventy-two per cent of mothers had received a complete course of antenatal steroids. The risk of Grade III intraventricular haemorrhage or intraparenchymal echodensity was associated with exposure to in utero inflammation if a complete course of antenatal steroids had not been received (P = 0.002). This association did not exist if a complete course of antenatal steroids was given (P = 0.62). Fourteen infants had cerebral palsy (7%). The presence of cerebral palsy was also associated with in utero inflammation in the absence of complete antenatal steroid cover (P = 0.03) and not in the presence of complete cover (P = 0.59). The mean general developmental quotient on Griffiths Mental Developmental Assessment at 12 months or 3 years was not affected by exposure to in utero inflammation regardless of antenatal steroid exposure. Conclusion: Risk of intraventricular haemorrhage or intraparenchymal echodensity and cerebral palsy was associated with in utero inflammation in the absence of a complete course of antenatal steroids. A complete course of antenatal steroids appeared to extinguish any association between in utero inflammation and adverse neurological outcome.
dc.publisherBlackwell Publishing Ltd
dc.sourceJournal of Paediatrics and Child Health
dc.subjectKeywords: beractant; dexamethasone; birth weight; brain hemorrhage; cerebral palsy; chorioamnionitis; data base; drug effect; encephalomalacia; female; follow up; gestational age; human; inflammation; major clinical study; male; nervous system development; neurolog Antenatal steroids; Cerebral palsy; Chorioamnionitis; Intraventricular haemorrhage; Periventricular leukomalacia; Premature infants
dc.titleAntenatal steriods may reduce adverse neurological outcome follow chorioamnionitis: Neurodevelopmental outcome and chorioamnionitis in premature infants
dc.typeJournal article
local.description.notesImported from ARIES
local.description.refereedYes
local.identifier.citationvolume41
dc.date.issued2005
local.identifier.absfor111403 - Paediatrics
local.identifier.ariespublicationMigratedxPub10152
local.type.statusPublished Version
local.contributor.affiliationKent, Alison, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationLomas, Fred, The Canberra Hospital
local.contributor.affiliationHurrion, Elizabeth, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationDahlstrom, Jane, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.startpage186
local.bibliographicCitation.lastpage190
local.identifier.doi10.1111/j.1440-1754.2005.00585.x
dc.date.updated2015-12-11T10:56:55Z
local.identifier.scopusID2-s2.0-18444374699
CollectionsANU Research Publications

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