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Survival and Neonatal and Neurodevelopmental Outcome of 24–29 Week Gestation Infants According to Primary Cause of Preterm Delivery

Authors

  • Peter H. Gray MD, FRCPI, DCH,

    Corresponding author
    1. Department of Neonatology Growth, Mater Misercordiae Hospitals, Brisbane
    2. Development Clinic, Mater Misercordiae Hospitals, Brisbane
      10 Department of Neonatology, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland 4101.
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    • 1

      Deputy Director of Neonatology.

  • Thomas M. Hurley MB, BS,

    1. Department of Neonatology Growth, Mater Misercordiae Hospitals, Brisbane
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    • 2

      Senior Paediatric Registrar.

  • Yvonne M. Rogers,

    1. Development Clinic, Mater Misercordiae Hospitals, Brisbane
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    • 3

      Research Assistant.

  • Michael J. O'Callaghan FRACP, BSc(Med),

    1. Development Clinic, Mater Misercordiae Hospitals, Brisbane
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    • 4

      Director of Child Development and Rehabilitation.

  • David I. Tudehope FRACP,

    1. Department of Neonatology Growth, Mater Misercordiae Hospitals, Brisbane
    2. Development Clinic, Mater Misercordiae Hospitals, Brisbane
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    • 5

      Director of Neonatology.

  • Yvonne R. Burns,

    1. Development Clinic, Mater Misercordiae Hospitals, Brisbane
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    • 6

      Associate Professor of Physiotherapy.

  • M. Phty PhD,

    1. Department of Neonatology Growth, Mater Misercordiae Hospitals, Brisbane
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  • Heather A. Mohay BSc(Hons), DipAppPsych, PhD

    1. Development Clinic, Mater Misercordiae Hospitals, Brisbane
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    • 7

      Associate Professor of Early Childhood.


10 Department of Neonatology, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland 4101.

Abstract

Summary: A total of 189 infants of 24–29 weeks' gestation were born in a regional perinatal centre during a 2-year period. They were divided into groups according to the primary cause of preterm delivery: antepartum haemorrhage (n=37, 20%), preeclampsia (n=27, 14%), preterm premature rupture of membranes (n=64, 34%), preterm labour (n=27, 14%), chorioamnionitis (n=16, 8%), other complications (n=18, 10%). The perinatal mortality rate (PMR) was 286/1,000 of whom 44% were stillbirths. The ‘other complication’ group had the highest PMR due to a large number of intrauterine deaths, with no differences in neonatal mortality between the groups. Preeclampsia was associated with an increased risk of necrotizing enterocolitis and chorioamnionitis was associated with an increased risk of periventricular haemorrhage. Follow-up to at least 2 years was performed in 122 (97%) of survivors. Cerebral palsy occurred in 7%, while 18% had neurodevelopmental disability. No relationship was found between primary cause of preterm delivery and outcome. This information should be of value in counselling parents when preterm delivery is imminent.

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