The ELGAN study of the brain and related disorders in extremely low gestational age newborns
Extremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities. To identify factors that contribute to brain damage in ELGANs. Multi-center cohort study. We enrolled 1506 ELGANs born before 28 weeks gestation at 14 sites; 1201 (80%) survived t...
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| Published in | Early human development Vol. 85; no. 11; pp. 719 - 725 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article Conference Proceeding |
| Language | English |
| Published |
Amsterdam
Elsevier Ireland Ltd
01.11.2009
Elsevier |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Extremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities.
To identify factors that contribute to brain damage in ELGANs.
Multi-center cohort study.
We enrolled 1506 ELGANs born before 28 weeks gestation at 14 sites; 1201 (80%) survived to 2 years corrected age. Information about exposures and characteristics was collected by maternal interview, from chart review, microbiologic and histological examination of placentas, and measurement of proteins in umbilical cord and early postnatal blood spots.
Indicators of white matter damage, i.e. ventriculomegaly and echolucent lesions, on protocol cranial ultrasound scans; head circumference and developmental outcomes at 24 months adjusted age, i.e., cerebral palsy, mental and motor scales of the Bayley Scales of Infant Development, and a screen for autism spectrum disorders.
ELGAN Study publications thus far provide evidence that the following are associated with ultrasongraphically detected white matter damage, cerebral palsy, or both: preterm delivery attributed to preterm labor, prelabor premature rupture of membranes, or cervical insufficiency; recovery of microorganisms in the placenta parenchyma, including species categorized as human skin microflora; histological evidence of placental inflammation; lower gestational age at delivery; greater neonatal illness severity; severe chronic lung disease; neonatal bacteremia; and necrotizing enterocolitis.
In addition to supporting a potential role for many previously identified antecedents of brain damage in ELGANs, our study is the first to provide strong evidence that brain damage in extremely preterm infants is associated with microorganisms in placenta parenchyma. |
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| AbstractList | Extremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities.
To identify factors that contribute to brain damage in ELGANs.
Multi-center cohort study.
We enrolled 1506 ELGANs born before 28 weeks gestation at 14 sites; 1201 (80%) survived to 2 years corrected age. Information about exposures and characteristics was collected by maternal interview, from chart review, microbiologic and histological examination of placentas, and measurement of proteins in umbilical cord and early postnatal blood spots.
Indicators of white matter damage, i.e. ventriculomegaly and echolucent lesions, on protocol cranial ultrasound scans; head circumference and developmental outcomes at 24 months adjusted age, i.e., cerebral palsy, mental and motor scales of the Bayley Scales of Infant Development, and a screen for autism spectrum disorders.
ELGAN Study publications thus far provide evidence that the following are associated with ultrasongraphically detected white matter damage, cerebral palsy, or both: preterm delivery attributed to preterm labor, prelabor premature rupture of membranes, or cervical insufficiency; recovery of microorganisms in the placenta parenchyma, including species categorized as human skin microflora; histological evidence of placental inflammation; lower gestational age at delivery; greater neonatal illness severity; severe chronic lung disease; neonatal bacteremia; and necrotizing enterocolitis.
In addition to supporting a potential role for many previously identified antecedents of brain damage in ELGANs, our study is the first to provide strong evidence that brain damage in extremely preterm infants is associated with microorganisms in placenta parenchyma. Extremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities. To identify factors that contribute to brain damage in ELGANs. Multi-center cohort study. We enrolled 1506 ELGANs born before 28 weeks gestation at 14 sites; 1201 (80%) survived to 2 years corrected age. Information about exposures and characteristics was collected by maternal interview, from chart review, microbiologic and histological examination of placentas, and measurement of proteins in umbilical cord and early postnatal blood spots. Indicators of white matter damage, i.e. ventriculomegaly and echolucent lesions, on protocol cranial ultrasound scans; head circumference and developmental outcomes at 24 months adjusted age, i.e., cerebral palsy, mental and motor scales of the Bayley Scales of Infant Development, and a screen for autism spectrum disorders. ELGAN Study publications thus far provide evidence that the following are associated with ultrasongraphically detected white matter damage, cerebral palsy, or both: preterm delivery attributed to preterm labor, prelabor premature rupture of membranes, or cervical insufficiency; recovery of microorganisms in the placenta parenchyma, including species categorized as human skin microflora; histological evidence of placental inflammation; lower gestational age at delivery; greater neonatal illness severity; severe chronic lung disease; neonatal bacteremia; and necrotizing enterocolitis. In addition to supporting a potential role for many previously identified antecedents of brain damage in ELGANs, our study is the first to provide strong evidence that brain damage in extremely preterm infants is associated with microorganisms in placenta parenchyma. Abstract Background Extremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities. Aim To identify factors that contribute to brain damage in ELGANs. Study design Multi-center cohort study. Subjects We enrolled 1506 ELGANs born before 28 weeks gestation at 14 sites; 1201 (80%) survived to 2 years corrected age. Information about exposures and characteristics was collected by maternal interview, from chart review, microbiologic and histological examination of placentas, and measurement of proteins in umbilical cord and early postnatal blood spots. Outcome measures Indicators of white matter damage, i.e. ventriculomegaly and echolucent lesions, on protocol cranial ultrasound scans; head circumference and developmental outcomes at 24 months adjusted age, i.e., cerebral palsy, mental and motor scales of the Bayley Scales of Infant Development, and a screen for autism spectrum disorders. Results ELGAN Study publications thus far provide evidence that the following are associated with ultrasongraphically detected white matter damage, cerebral palsy, or both: preterm delivery attributed to preterm labor, prelabor premature rupture of membranes, or cervical insufficiency; recovery of microorganisms in the placenta parenchyma, including species categorized as human skin microflora; histological evidence of placental inflammation; lower gestational age at delivery; greater neonatal illness severity; severe chronic lung disease; neonatal bacteremia; and necrotizing enterocolitis. Conclusions In addition to supporting a potential role for many previously identified antecedents of brain damage in ELGANs, our study is the first to provide strong evidence that brain damage in extremely preterm infants is associated with microorganisms in placenta parenchyma. Extremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities.BACKGROUNDExtremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities.To identify factors that contribute to brain damage in ELGANs.AIMTo identify factors that contribute to brain damage in ELGANs.Multi-center cohort study.STUDY DESIGNMulti-center cohort study.We enrolled 1506 ELGANs born before 28 weeks gestation at 14 sites; 1201 (80%) survived to 2 years corrected age. Information about exposures and characteristics was collected by maternal interview, from chart review, microbiologic and histological examination of placentas, and measurement of proteins in umbilical cord and early postnatal blood spots.SUBJECTSWe enrolled 1506 ELGANs born before 28 weeks gestation at 14 sites; 1201 (80%) survived to 2 years corrected age. Information about exposures and characteristics was collected by maternal interview, from chart review, microbiologic and histological examination of placentas, and measurement of proteins in umbilical cord and early postnatal blood spots.Indicators of white matter damage, i.e. ventriculomegaly and echolucent lesions, on protocol cranial ultrasound scans; head circumference and developmental outcomes at 24 months adjusted age, i.e., cerebral palsy, mental and motor scales of the Bayley Scales of Infant Development, and a screen for autism spectrum disorders.OUTCOME MEASURESIndicators of white matter damage, i.e. ventriculomegaly and echolucent lesions, on protocol cranial ultrasound scans; head circumference and developmental outcomes at 24 months adjusted age, i.e., cerebral palsy, mental and motor scales of the Bayley Scales of Infant Development, and a screen for autism spectrum disorders.ELGAN Study publications thus far provide evidence that the following are associated with ultrasongraphically detected white matter damage, cerebral palsy, or both: preterm delivery attributed to preterm labor, prelabor premature rupture of membranes, or cervical insufficiency; recovery of microorganisms in the placenta parenchyma, including species categorized as human skin microflora; histological evidence of placental inflammation; lower gestational age at delivery; greater neonatal illness severity; severe chronic lung disease; neonatal bacteremia; and necrotizing enterocolitis.RESULTSELGAN Study publications thus far provide evidence that the following are associated with ultrasongraphically detected white matter damage, cerebral palsy, or both: preterm delivery attributed to preterm labor, prelabor premature rupture of membranes, or cervical insufficiency; recovery of microorganisms in the placenta parenchyma, including species categorized as human skin microflora; histological evidence of placental inflammation; lower gestational age at delivery; greater neonatal illness severity; severe chronic lung disease; neonatal bacteremia; and necrotizing enterocolitis.In addition to supporting a potential role for many previously identified antecedents of brain damage in ELGANs, our study is the first to provide strong evidence that brain damage in extremely preterm infants is associated with microorganisms in placenta parenchyma.CONCLUSIONSIn addition to supporting a potential role for many previously identified antecedents of brain damage in ELGANs, our study is the first to provide strong evidence that brain damage in extremely preterm infants is associated with microorganisms in placenta parenchyma. |
| Author | O'Shea, T.M. Kuban, K.C.K. Allred, E.N. Paneth, N. Hirtz, D. Leviton, A. Dammann, O. |
| AuthorAffiliation | 1 Department of Pediatrics (Neonatology), Wake Forest University Health Sciences, Winston-Salem, NC 7 Department of Epidemiology, Michigan State University, East Lansing, MI 5 National Institute of Neurological Disorders and Stroke, Bethesda, MD 3 Department of Pediatrics (Newborn Medicine), Floating Hospital for Children at Tufts Medical Center, Boston, MA 4 Perinatal Neuroepidemiology Unit, Departments of Gynecology and Pediatrics, Hannover Medical School, Germany 6 Department of Pediatrics (Pediatric Neurology), Boston Medical Center, Boston, MA 2 Neuroepidemiology Unit, Children’s Hospital of Boston, Boston, MA |
| AuthorAffiliation_xml | – name: 3 Department of Pediatrics (Newborn Medicine), Floating Hospital for Children at Tufts Medical Center, Boston, MA – name: 6 Department of Pediatrics (Pediatric Neurology), Boston Medical Center, Boston, MA – name: 2 Neuroepidemiology Unit, Children’s Hospital of Boston, Boston, MA – name: 5 National Institute of Neurological Disorders and Stroke, Bethesda, MD – name: 7 Department of Epidemiology, Michigan State University, East Lansing, MI – name: 1 Department of Pediatrics (Neonatology), Wake Forest University Health Sciences, Winston-Salem, NC – name: 4 Perinatal Neuroepidemiology Unit, Departments of Gynecology and Pediatrics, Hannover Medical School, Germany |
| Author_xml | – sequence: 1 givenname: T.M. surname: O'Shea fullname: O'Shea, T.M. email: moshea@wfubmc.edu organization: Department of Pediatrics (Neonatology), Wake Forest University Health Sciences, Medical Center Blvd, Winston-Salem, NC 27157, USA – sequence: 2 givenname: E.N. surname: Allred fullname: Allred, E.N. organization: Neuroepidemiology Unit, Children's Hospital of Boston, Boston, MA, USA – sequence: 3 givenname: O. surname: Dammann fullname: Dammann, O. organization: Neuroepidemiology Unit, Children's Hospital of Boston, Boston, MA, USA – sequence: 4 givenname: D. surname: Hirtz fullname: Hirtz, D. organization: National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA – sequence: 5 givenname: K.C.K. surname: Kuban fullname: Kuban, K.C.K. organization: Department of Pediatrics (Pediatric Neurology), Boston Medical Center, Boston, MA, USA – sequence: 6 givenname: N. surname: Paneth fullname: Paneth, N. organization: Department of Epidemiology, Michigan State University, East Lansing, MI, USA – sequence: 7 givenname: A. surname: Leviton fullname: Leviton, A. organization: Neuroepidemiology Unit, Children's Hospital of Boston, Boston, MA, USA |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22245095$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/19765918$$D View this record in MEDLINE/PubMed |
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| Keywords | Pregnancy Autism Cerebral palsy ELGAN Chorioamnionitis Prematurity M-CHAT Preeclampsia Developmental disability SNAP Autism spectrum disorder Modified Checklist for Autism in Toddlers extremely low gestational age newborn Score for Acute Neonatal Physiology Human Nervous system diseases Pregnancy disorders Central nervous system Developmental disorder Pregnancy toxemia Gestational age Cerebral disorder Encephalon Pervasive developmental disorder Newborn Central nervous system disease Developmental stage |
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| Snippet | Extremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities.
To identify factors that contribute to... Abstract Background Extremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities. Aim To identify... Extremely low gestational age newborns (ELGANs) are at increased risk for structural and functional brain abnormalities.BACKGROUNDExtremely low gestational age... |
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| SubjectTerms | Adult Advanced Basic Science Autism Autism spectrum disorder Biological and medical sciences Brain Diseases - complications Brain Diseases - congenital Brain Diseases - diagnosis Brain Diseases - etiology Bronchopulmonary Dysplasia - complications Bronchopulmonary Dysplasia - epidemiology Cerebral palsy Child Development - physiology Chorioamnionitis Cohort Studies Developmental disability Embryology: invertebrates and vertebrates. Teratology Female Fundamental and applied biological sciences. Psychology Gestational Age Humans Infant, Extremely Low Birth Weight - growth & development Infant, Extremely Low Birth Weight - physiology Infant, Newborn Infant, Premature - growth & development Infant, Premature - physiology Infant, Premature, Diseases - diagnosis Infant, Premature, Diseases - epidemiology Infant, Premature, Diseases - etiology Neonatal and Perinatal Medicine Perinatal Care Placenta Diseases - epidemiology Preeclampsia Pregnancy Pregnancy Complications, Infectious - epidemiology Prematurity Risk Factors Young Adult |
| Title | The ELGAN study of the brain and related disorders in extremely low gestational age newborns |
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