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Neurodevelopmental outcomes of premature infants treated with l-arginine for prevention of necrotising enterocolitis


Dr Harish Jayant Amin, Room C4-615, Department of Pediatrics, Alberta Children's Hospital, 2888 Shaganappi Trail N.W, Calgary, Alberta, Canada T3B 6A8. Fax: +1 403 955 3045; email:


Aim:  This study aimed to compare the long-term neurodevelopmental outcomes at 36 months adjusted age in preterm infants (birth weight ≤ 1250 gm) who received supplementation with l-arginine during the first 28 days of life with controls.

Methods:  Surviving infants enrolled in a randomised control study of l-arginine supplementation were prospectively followed longitudinally to determine their neurodevelopmental outcomes at 36 months of adjusted age. Neurologic examination and neurodevelopmental assessments were performed by examiners who were unaware of the original treatment assignments.

Results:  A total of 132 children (95% of survivors) were evaluated at 36 months adjusted age. In the group given l-arginine, 5 of 61 (8.1%) had major neurodevelopmental disabilities, defined as the presence of one or more of cerebral palsy, cognitive delay (cognitive index <70), bilateral blindness or bilateral hearing loss requiring hearing aids as compared with 9 of 71 (12.6%) in the placebo group (relative risk, 0.64; 95 % confidence interval, 0.22–1.82; P= 0.40).

Conclusions:  There is no increase in neurodevelopmental disability in preterm infants who received l-arginine supplementation.