Natarajan et al evaluated risk factors for cognitive impairment in neonates with extremely low birth weight. Bronchopulmonary dysplasia can have a negative impact on the patient. The authors are from Wayne State University, Research Triangle International, NIH, Brown University, University of Iowa, Emory University and Case Western Reserve University.
Outcome: cognitive score < 70 (Bayley Scales of Infant Development III)
Parameters:
(1) gestational age in weeks
(2) sex
(3) size
(4) maternal education (less than high school, high school, beyond high school)
(5) surgical necrotizing enterocolitis (NEC)
(6) intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL)
(7) physiologic bronchopulmonary dysplasia (Walsh et al)
Parameter
Finding
Odds Ratio
gestational age in weeks
0.91 ^ ((weeks)-23)
sex
female
1
male
1.39
size
small for gestational age
2.6
other
1
maternal education
less than high school
1.41
unknown
1.79
high school or beyond
1
surgical NEC
no
1
yes
3.35
IVH or PVL
no
1
yes
3.97
physiologic BPD
no
1
yes
2.41
where:
• The odds ratio for gestational age is affected by each additional week of gestation. The minimum viable gestational age is taken as 23 weeks. If the actual gestational age is used then the odds ratio generated does not make sense.
cumulative odds ratio for cognitive impairment =
= PRODUCT(odds ratios for all of the parameters)
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