Paediatrics: Outcome following prematurity

2021-03-09 12:00 AM

The risk of complications and associated morbidity/mortality steadily lessen as gestation advances.

Outcome following prematurity

The risk of complications and associated morbidity/mortality steadily lessen as gestation advances. Infants who are well in the first 24hr and are >32wks gestation are at low risk of suffering adverse outcomes. The EPICure and EPICure2 studies give the best available guide to likely outcome in the UK for infants born at less than 26wks gestation (Table 6.1).1

Typical disabilities were;

  • Cerebral palsy, most commonly spastic (diplegia > quadriplegia > hemiplegia).
  • Squint (strabismus).
  • Blindness.
  • Hearing loss.
  • Epilepsy.
  • Cognitive impairment and behavioural disorders, e.g. attention deficit hyperactivity disorder.

Generally smaller, more immature infants will have a poorer outcome than larger, mature babies.

Knowledge of your own unit’s outcome is important. However, the numbers will be small, and national figures (where available) should be used. Note that many things influence the outcome, e.g. a singleton infant, born spontaneously at 25wks gestation after an otherwise uncomplicated pregnancy in a mother treated with 48hr of steroids, has a better prognosis than a triplet born suddenly at 26wks after the mother developed severe chorioamnionitis.