Extremely low birth weight (ELBW) infants are prone to impaired neurodevelopment.Objective:
The aim was to determine long-term neurodevelopmental outcome in ELBW infants after postnatal 17β-estradiol (E2) and progesterone (P) replacement.Design:
At 5-yr corrected age, ELBW infants were assessed for standardized cognitive and neurological outcome after postnatal randomized E2 and P replacement or placebo administration.Setting:
The follow-up examination was performed in a neuropediatric ambulatory care center.Patients:
Sixty-one of 71 surviving infants (86%) were available for follow-up.Main Outcome Measures:
Cognitive and neurological outcome was evaluated using the Kaufmann Assessment Battery for Children, the Gross Motor Function Classification Scale, and clinical neurological examination.Results:
No significant differences were found between the replacement and placebo groups for the Gross Motor Function Classification Scale, presence of paresis, cerebral palsy, spasticity, and ametropia. However, a significant time-response relationship was found with E2 and P replacement. Every day of treatment reduced the risk for cerebral palsy (P = 0.03), spasticity (P = 0.01), and ametropia (P = 0.01).Conclusion:
Postnatal E2 and P replacement may have potential in improving neurodevelopmental outcome in ELBW infants. Larger trials are needed to test this new hypothesis.