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Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery

We opted to investigate whether a critical threshold exists for long-term pediatric neurological morbidity, and cerebral palsy (CP), in preterm delivery, via a population-based cohort analysis. Four study groups were classified according to their gestational age at birth: 24–27.6, 28–31.6, 32–36.6 w...

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Autores principales: Zer, Shiran, Wainstock, Tamar, Sheiner, Eyal, Miodownik, Shayna, Pariente, Gali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269302/
https://www.ncbi.nlm.nih.gov/pubmed/34209950
http://dx.doi.org/10.3390/jcm10132919
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author Zer, Shiran
Wainstock, Tamar
Sheiner, Eyal
Miodownik, Shayna
Pariente, Gali
author_facet Zer, Shiran
Wainstock, Tamar
Sheiner, Eyal
Miodownik, Shayna
Pariente, Gali
author_sort Zer, Shiran
collection PubMed
description We opted to investigate whether a critical threshold exists for long-term pediatric neurological morbidity, and cerebral palsy (CP), in preterm delivery, via a population-based cohort analysis. Four study groups were classified according to their gestational age at birth: 24–27.6, 28–31.6, 32–36.6 weeks and term deliveries, evaluating the incidence of long-term hospitalizations of the offspring due to neurological morbidity. Cox proportional hazard models were performed to control for confounders. A Kaplan–Meier survival curve was used to compare the cumulative neurological morbidity incidence for each group. A total of 220,563 deliveries were included: 0.1% (118) occurred at 24–27.6 weeks of gestation, 0.4% (776) occurred at 28–31.6 weeks of gestation, 6% (13,308) occurred at 32–36.6 weeks of gestation and 93% (206,361) at term. In a Cox model, while adjusting for confounders, delivery before 25 weeks had a 3.9-fold risk for long-term neurological morbidity (adjusted HR (hazard ratio) = 3.9, 95% CI (confidence interval) 2.3–6.6; p < 0.001). The Kaplan–Meier survival curve demonstrated a linear association between long-term neurological morbidity and decreasing gestational age. In a second Cox model, adjusted for confounders, infants born before 25 weeks of gestation had increased rates of CP (adjusted HR = 62.495% CI 25.6–152.4; p < 0.001). In our population, the critical cut-off for long-term neurological complications is delivery before 25 weeks gestation.
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spelling pubmed-82693022021-07-10 Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery Zer, Shiran Wainstock, Tamar Sheiner, Eyal Miodownik, Shayna Pariente, Gali J Clin Med Article We opted to investigate whether a critical threshold exists for long-term pediatric neurological morbidity, and cerebral palsy (CP), in preterm delivery, via a population-based cohort analysis. Four study groups were classified according to their gestational age at birth: 24–27.6, 28–31.6, 32–36.6 weeks and term deliveries, evaluating the incidence of long-term hospitalizations of the offspring due to neurological morbidity. Cox proportional hazard models were performed to control for confounders. A Kaplan–Meier survival curve was used to compare the cumulative neurological morbidity incidence for each group. A total of 220,563 deliveries were included: 0.1% (118) occurred at 24–27.6 weeks of gestation, 0.4% (776) occurred at 28–31.6 weeks of gestation, 6% (13,308) occurred at 32–36.6 weeks of gestation and 93% (206,361) at term. In a Cox model, while adjusting for confounders, delivery before 25 weeks had a 3.9-fold risk for long-term neurological morbidity (adjusted HR (hazard ratio) = 3.9, 95% CI (confidence interval) 2.3–6.6; p < 0.001). The Kaplan–Meier survival curve demonstrated a linear association between long-term neurological morbidity and decreasing gestational age. In a second Cox model, adjusted for confounders, infants born before 25 weeks of gestation had increased rates of CP (adjusted HR = 62.495% CI 25.6–152.4; p < 0.001). In our population, the critical cut-off for long-term neurological complications is delivery before 25 weeks gestation. MDPI 2021-06-29 /pmc/articles/PMC8269302/ /pubmed/34209950 http://dx.doi.org/10.3390/jcm10132919 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zer, Shiran
Wainstock, Tamar
Sheiner, Eyal
Miodownik, Shayna
Pariente, Gali
Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery
title Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery
title_full Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery
title_fullStr Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery
title_full_unstemmed Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery
title_short Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery
title_sort identifying the critical threshold for long-term pediatric neurological hospitalizations of the offspring in preterm delivery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269302/
https://www.ncbi.nlm.nih.gov/pubmed/34209950
http://dx.doi.org/10.3390/jcm10132919
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