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Summary of Infants Weighing 500 Grams or Less

Completed
Conditions
Infant, Extremely Low Birth Weight
Microcephaly
Interventions
Diagnostic Test: Microcephaly
Registration Number
NCT05322980
Lead Sponsor
Nagano Children's Hospital
Brief Summary

This is a retrospective single-center cohort study. The comparison in short- and long-term outcomes will be made between those with and without primary microcephaly in infants weighing ≤ 500 g.

Detailed Description

This is a retrospective single-center cohort study. The study setting is a level IV neonatal intensive care unit (NICU) at Nagano Children's Hospital in Nagano, Japan. We will retrospectively collect the data of those who were admitted to Nagano Children's Hospital NICU between January 1, 2015, and December 31, 2019. Eligible infants will be identified using our neonatal database and clinical records. The extracted data includes maternal background information and clinical course, infant's status at birth, the clinical course in NICU, and the follow-up data at 6 and 18 months of corrected age.

Among the eligible infants, those with a z score of birth head circumference \< -2 will be classified into the Microcephaly group and others into the Control group. The z score is calculated using the Japanese growth standard.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
22
Inclusion Criteria
  • Live-born infants weighing ≤ 500 g at birth
  • Infants whose clinical course is available in the electronic medical record
Exclusion Criteria
  • Stillbirths
  • Infants who received only palliative care at birth
  • Outborn infants
  • Infants whose assessment at 3 years of age not completed at data analysis

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
MicrocephalyMicrocephalyInfants with primary microcephaly.
Primary Outcome Measures
NameTimeMethod
Rate of neurodevelopmental impairment3 years of age

Having at least one of the following conditions: cognitive impairment, cerebral palsy, visual impairment, or hearing impairment. Cognitive impairment was defined as a modified DQ score of ≤ 70 using the Kyoto Scale of Psychological Development. CP was defined as (1) a non-progressive disorder of the central nervous system appearing in the early years of life and clinically characterized by a persistent but not unchanging impairment of movement and posture and/or (2) the Gross Motor Function Classification System level ≥ II. Visual impairment was defined as unilateral or bilateral blindness, or any other condition requiring corrective lenses, which were diagnosed or determined by ophthalmologists. Hearing impairment was defined as unilateral or bilateral hearing loss that requires a hearing aid. The diagnosis of hearing loss was made by otolaryngologists using auditory steady-state response.

Secondary Outcome Measures
NameTimeMethod
HeightAt 3 years of age

Physical measurement.

Rate of need for surgery for patent ductus arteriosusIn neonatal intensive care unit, an average of up to 4 weeks of life

Patent ductus arteriosus is diagnosed by neonatologists using echocardiography and clinical signs.

Modified developmental quotientAt 3 years of age

Modified developmental quotient is calculated by dividing developmental age (measured by the Kyoto Scale of Psychological Development) by the corrected age.

Rate of severe bronchopulmonary dysplasiaAt 36 weeks' postmenstrual age

The definition of bronchopulmonary dysplasia proposed by the National Institute of Child Health and Human Development is used to classify the severity of bronchopulmonary dysplasia. Those who need ≥ 30% of oxygen or any mechanical respiratory support at 36 weeks of gestation are classified as having severe bronchopulmonary dysplasia.

Rate of need for treatment for retinopathy of prematurityIn neonatal intensive care unit, an average of up to 40 weeks' postmenstrual age

The diagnosis of retinopathy of prematurity and the decision on the need for treatment were made by ophthalmologic examination.

WeightAt 3 years of age

Physical measurement.

Rate of hearing impairmentAt 3 years of age

Hearing impairment is defined as unilateral or bilateral hearing loss that requires a hearing aid. The diagnosis of hearing loss was made by otolaryngologists using auditory steady-state response.

Rate of those who need rehospitalizationAfter 18 months of corrected age unit until 3 years of age

Need for rehospitalization.

Postmenstrual ageAt discharge, an average at 40 weeks' postmenstrual age

Postmenstrual age is calculated based on their gestational age and date at birth.

Length of hospital stayIn neonatal intensive care unit, an average at 40 weeks' postmenstrual age

The initial hospitalization.

Rate of those who need tracheostomyAt 3 years of age

Need for tracheostomy.

Rate of those who need tube feeding or gastrostomyAt 3 years of age

Need for tube feeding or gastrostomy.

Rate of cerebral palsyAt 3 years of age

Cerebral palsy is defined as (1) a non-progressive disorder of the central nervous system appearing in early years of life and clinically characterized by a persistent but not unchanging impairment of movement and posture and/or (2) the Gross Motor Function Classification System level ≥ II.

Rate of periventricular leukomalaciaIn neonatal intensive care unit, an average of up to 40 weeks' postmenstrual age

Periventricular leukomalacia is diagnosed using head ultrasound or magnetic resonance imaging, typically cysts formation in the periventricular white matter.

Rate of visual impairmentAt 3 years of age

Visual impairment is defined as unilateral or bilateral blindness, or any other condition requiring corrective lenses, which were diagnosed or determined by ophthalmologists.

Rate of those who need home oxygen therapyAt 3 years of age

Need for home oxygen therapy.

Survival rateAt 3 years of age

Survival rate is the proportion of those have survived.

Rate of severe intraventricular hemorrhageIn neonatal intensive care unit, an average of up to 2 weeks of life

Intraventricular hemorrhage is diagnosed by neonatologists using head ultrasound. Severe IVH was defined as grade III or IV by the classification of Papile.

Rate of necrotizing enterocolitisIn neonatal intensive care unit, an average of up to 2 weeks of life

The diagnosis with necrotizing enterocolitis.

Need for home oxygen therapyAt discharge, an average at 40 weeks' postmenstrual age

Need for home oxygen therapy.

TracheostomyIn neonatal intensive care unit, an average at 40 weeks' postmenstrual age

Need for tracheostomy.

Rate of sepsisIn neonatal intensive care unit, an average of up to 4 weeks of life

Sepsis is defined as septicemia or bacteremia with a positive culture result of the blood and/or cerebrospinal fluid.

LengthAt 40 weeks' postmenstrual age or at discharge (approximately 40 weeks' postmenstrual age)

Physical measurement.

Head circumferenceAt 3 years of age

Physical measurement.

Trial Locations

Locations (1)

Nagano Children's Hospital

🇯🇵

Azumino, Nagano, Japan

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