The members of ELGAN study investigators are mentioned in Appendix.
The clustering of disorders in infants born before the 28th week of gestation
Article first published online: 6 SEP 2010
© 2010 The Author(s)/Acta Pædiatrica © 2010 Foundation Acta Pædiatrica
Volume 99, Issue 12, pages 1795–1800, December 2010
How to Cite
Leviton, A., Dammann, O., Engelke, S., Allred, E., Kuban, K. C., O’Shea, T. M., Paneth, N. and for the ELGAN study investigators (2010), The clustering of disorders in infants born before the 28th week of gestation. Acta Paediatrica, 99: 1795–1800. doi: 10.1111/j.1651-2227.2010.01973.x
- Issue published online: 29 OCT 2010
- Article first published online: 6 SEP 2010
- Accepted manuscript online: 12 AUG 2010 12:00AM EST
- Received 14 June 2010; revised 30 July 2010; accepted 3 August 2010.
- Bronchopulmonary dysplasia;
- Necrotizing enterocolitis;
- Retinopathy of prematurity;
- White matter damage
Aim: To see whether disorders prevalent in infants born extremely preterm cluster.
Design: Observational cohort study.
Setting: University-affiliated newborn intensive care nurseries.
Subjects: One thousand two hundred and twenty-three infants born before the 28th week of gestation who survived until 36 weeks postmenstrual age when the diagnosis of bronchopulmonary dysplasia (BPD) could be made.
Main outcome measures: Cerebral white matter damage (an echolucent lesion, or moderate or severe ventriculomegaly on a protocol cranial ultrasound scan), BPD, retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC) and early and late bacteremia.
Results: After adjustment for gestational age, children who had severe NEC (Bell stage IIIb) were at increased risk of cerebral white matter damage, severe ROP (stage 3+), and severe BPD (defined as both oxygen and ventilator dependent). Children who had early bacteremia were at increased risk of late bacteremia and severe ROP. Those who had severe ROP were at increased risk of severe BPD and both early and late bacteremia.
Conclusions: Necrotizing enterocolitis is the disorder common to most of the clusters, but we do not know if its onset occurred before the others. Organ-damage-promoting substances, however, have been found in the circulation of newborn animals with bowel inflammation, supporting the view that NEC contributes to the damage of other organs.