J. D. Arnold

Predictive value of the Griffiths assessment in extremely low birthweight infants

Objective: To assess the relationship between the Griffiths Mental Development Scales at 1 and 3 years and the Stanford‐Binet Intelligence Scale (S‐B) and Beery Test of Visual‐Motor Integration (VMI) at 5 years in extremely low birthweight (ELBW) children.

Ocular sequelae in extremely premature infants at 5 years of age.

Objective To report long‐term ophthalmological sequelae in extremely premature infants at 5 years and to determine the relationship between neonatal variables (including retinopathy of prematurity; ROP) and the 5 year ophthalmological outcome of these infants.

Extremely low birthweight infants at 3 years: A developmental profile

This study documents the neurodevelopmental outcome at 3 years of 52 of 55 extremely low birthweight (ELBW) survivors (survival rate 49%) born in a tertiary maternity centre from July 1985 through December 1988, and examines more closely the developmental profile of the neurologically normal survivors. At 3 years, 6 (12%) children had severe neurodevelopmental impairment (severe cerebral palsy, blindness, deafness or a General Quotient (GQ)<70 on the Griffiths Scales), 11 (21 %) had mild to moderate impairment and 35 (67%) had no neurosensory impairment and normal development (GQ≥ 85). Significant risk factors for severe impairment were stage 3 or 4 retinopathy of prematurity (odds ratio [OR] 21.5), treatment with postnatal steroids (OR 21), grade III or IV intraventricular haemorrhage (OR 11) and supplemental oxygen at ‘term’(OR 6.4). The developmental profile of the 35 neurologically normal children revealed a significant weakness in eye and hand coordination skills and a relative strength in hearing and speech skills. Early recognition of this developmental profile may allow implementation of more appropriate preschool programmes for ELBW children.

Risk factors for sensorineural hearing loss in extremely premature infants

Objective: To identify potentially preventable risk factors for sensorineural hearing loss (SNHL) in extremely premature infants.

Early neonatal hyperkalaemia in the extremely premature newborn infant.

Abstract The incidence of hyperkalaemia in 43 consecutive infants born at less than 28 weeks gestation and cared for in our neonatal intensive care unit was documented. Plasma K levels were related to indices of renal function as well as to the degree of illness in the infants. The mean gestational age was 26.0 weeks (range 24–27 weeks) and the mean birthweight was 815 g (range 395–1170 g).

Vitamin A status in preterm neonates with and without chronic lung disease

It has been proposed that there is an association between vitamin A (VA) deficiency and the development of chronic lung disease (CLD) in preterm infants. This study was designed to measure the VA status in preterm infants and to compare the results in the group of babies who developed CLD with the group who did not. Vitamin A status was assessed by measuring plasma VA, retinol binding protein (RBP) and the plasma VA:RBP molar ratio in 25 infants of less than 31 weeks gestation during the first 28 days of life. Eleven babies developed CLD and 14 did not. There was no significant difference in plasma VA levels between the CLD and non CLD groups during the first 28 days. The majority of infants had adequate VA status, with a subgroup being deficient.

Survey of the definition and screening of neonatal hypoglycaemia in Australia

Objective: To determine the approach to identifying neonatal hypoglycaemia and the definition of neonatal hypoglycaemia used by neonatal paediatricians in Australian Level 3 neonatal intensive care units (NICU).

Adrenocortical responsiveness in neonates weaned from the ventilator with dexamethasone.

Adrenocortical responsiveness was assessed in eight very low birthweight neonates who had bronchopulmonary dysplasia and had been weaned from mechanical ventilation using dexamethasone. Three of the eight infants did not respond to ACTH stimulation during the first week after cessation of dexamethasone, but all three responded normally when retested at least 1 month later. The present authors have thus demonstrated that some infants have at least temporary adrenocortical unresponsiveness after prolonged courses of glucocorticoid therapy, and suggest that adrenocortical function should be assessed in all infants who are weaned from mechanical ventilation using dexamethasone.

Short-term outcome of mechanically ventilated infants weighing more than 2499 g at birth : a population based study

Abstract: Very little data exist describing the neonatal outcome of infants of birthweight 2500 g or more who require mechanical ventilation. Our aim was to collect population‐based data on such infants in New South Wales (NSW), and to monitor their neonatal morbidity, mortality to 1 year of age and the associated risk factors. The study group (NICUS infants) comprised all 341 infants weighing >2499 g who were admitted to the seven neonatal intensive care units in New South Wales and mechanically ventilated for 4 h or more between 1 January and 31 December, 1987.

Neonatal outcome in a randomized, controlled trial of low-dose aspirin in high-risk pregnancies

To determine the value of low‐dose aspirin in high‐risk pregnancies, and assess its impact on fetal growth, as well as on perinatal mortality and morbidity.