Mechanical Ventilation and Cerebral Palsy

Abstract

The article by Laptook et al1 in the March 2005 issue of Pediatrics offered an interesting analysis of varying risk factors related to the development of cerebral palsy (CP) and neurodevelopmental delay (NDD) in extremely low birth weight (ELBW) infants. Despite having normal head ultrasound results, the incidence of CP and NDD in ELBW infants was almost 30%. Factors associated with CP/NDD were male gender, multiple births, decreasing birth weight, and increasing duration of conventional mechanical ventilation (MV). The relation of MV duration and CP retained its significance after controlling for other possible confounders in a multiple-regression model. For example, in a group of ELBW infants with the same gestational age, birth weight, gender, race, prenatal history, socioeconomic status, insurance type, use of surfactant and postnatal steroids, and incidence of pneumothorax, necrotizing enterocolitis, and late-onset sepsis, an infant would have a 20% higher chance of developing CP/NDD if he or she were maintained an additional 10 days on MV. The impact … Reprint requests to (H.A.) Department of Neonatology, George Washington University Hospital, 900 23rd St NW, Suite G-2092, Washington, DC 20037. E-mail: haly{at}mfa.gwu.edu