School-age outcomes of very low birth weight infants in the indomethacin intraventricular hemorrhage prevention trial.

Abstract

OBJECTIVE:

The cohort consisted of 328 very low birth weight infants (600-1250 g birth weight) who were enrolled in the low-dose prophylactic indomethacin prevention trial and were intraventricular hemorrhage (IVH) negative at 6 postnatal hours. The objective was to determine the effects of both IVH and indomethacin on cognitive, language, and achievement performance at 8 years of age.

METHODS:

The cohort was divided into 4 subgroups for analysis: indomethacin plus IVH, indomethacin no IVH, saline plus IVH, and saline with no IVH. The children were evaluated prospectively at 8 years of age with a neurologic assessment, history of school performance, and a battery of cognitive, academic, behavioral, and functional assessments.

RESULTS:

Children in both IVH groups had more cerebral palsy; more hearing impairment; lower daily living skills scores; lower IQ, vocabulary, and reading and mathematics achievement test scores; and greater educational resource needs. With logistic regression analyses grade 3 to 4 IVH, periventricular leukomalacia and/or ventriculomegaly, male gender, maternal education, and language spoken in the home contributed to outcomes. No effects of indomethacin or gestational age were identified.

CONCLUSIONS:

Although biological factors including IVH, ventriculomegaly, and periventricular leukomalacia contribute significantly to school age outcomes among very low birth weight survivors at 8 years of age, social and environmental factors including maternal level of education and primary language spoken in the home are also important contributors to outcome.

• Authors: Betty R Vohr, Walter C Allan, Michael Westerveld, Karen C Schneider, Karol H Katz, Robert W Makuch, Laura R Ment
• Journal: Pediatrics (Pediatrics) Vol. 111 Issue 4 Pt 1 Pg. e340-6 (Apr 2003) ISSN: 1098-4275 [Electronic] United States
• PMID: 12671149 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Indomethacin

Topics

• Cerebral Hemorrhage (prevention & control)
• Cerebral Palsy (epidemiology)
• Cerebral Ventricles (drug effects, pathology)
• Child
• Cohort Studies
• Developmental Disabilities (epidemiology)
• Female
• Hearing Loss (epidemiology)
• Humans
• Indomethacin (therapeutic use)
• Infant
• Infant, Newborn
• Infant, Very Low Birth Weight (physiology, psychology)
• Intelligence Tests (statistics & numerical data)
• Leukomalacia, Periventricular (epidemiology)
• Male
• Needs Assessment (statistics & numerical data)
• Prospective Studies
• Regression Analysis