Neurodevelopmental Follow-Up at Five Years Corrected Age of Extremely Low Birth Weight Infants after Postnatal Replacement of 17β-Estradiol and Progesterone

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Abstract

Context:

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.

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