{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:10:05Z","timestamp":1790849405848,"version":"4.1.0"},"reference-count":15,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"published-print":{"date-parts":[[1999,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>AIM<\/jats:title>\n                  <jats:p>To evaluate the effects of changing perinatal practice on outcome in terms of cranial ultrasound appearances and subsequent cerebral palsy rates in survivors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A tertiary neonatal centre based prospective cohort study was undertaken of very low birthweight infants, in three 4 year periods: 1982\u20135, 1986\u20139, 1990\u20133. Rates of survival, parenchymal cerebral haemorrhage (PH), and leucomalacia on cerebral ultrasound scans, and cerebral palsy (CP) at the age of 3 years were compared. Antenatal steroid prophylaxis and postnatal surfactant use were also compared.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>VLBW infants (1722) were admitted over the 12 years, of whom 1268 (73.6%) were discharged home. Neonatal survival increased significantly over the three periods (69.2%, 72.9%, 79.7%; p&lt;0.0001). PH declined from 14.9% to 10.5% (p=0.032) after 1990 as did CP rate (10.9% to 7.3%; p=0.046). The use of antenatal steroids and postnatal surfactant greatly increased during this period. Steroid use was significantly associated with increased survival (OR 3.34, 2.31\u20134.79), decreased PH (OR 0.44, 0.28\u20130.71), and decreased risk of CP in survivors (OR 0.47, 0.27\u20130.81) after standardising for gestation, birthweight, sex, place and mode of delivery. Similar effects for surfactant did not remain significant after steroid use had been accounted for.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>Improved survival in VLBW infants since 1990 has been accompanied by a fall in PH and subsequent CP rates in survivors. This change is most likely to be due to the greater use of antenatal steroid prophylaxis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fn.80.2.f115","type":"journal-article","created":{"date-parts":[[2009,4,8]],"date-time":"2009-04-08T11:39:47Z","timestamp":1239190787000},"page":"F115-F117","source":"Crossref","is-referenced-by-count":59,"title":["Trends in incidence of cranial ultrasound lesions and cerebral palsy in very low birthweight infants 1982\u201393"],"prefix":"10.1136","volume":"80","author":[{"given":"Richard W I","family":"Cooke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1999,3,1]]},"reference":[{"key":"2025090515084870000_80.2.F115.1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1469-8749.1964.tb10791.x","article-title":"Terminology and classification of cerebral palsy.","volume":"6","author":"Bax","year":"1964","journal-title":"Dev Med Child Neurol"},{"key":"2025090515084870000_80.2.F115.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199401203300308"},{"key":"2025090515084870000_80.2.F115.3","doi-asserted-by":"publisher","DOI":"10.1136\/adc.62.9.931"},{"key":"2025090515084870000_80.2.F115.4","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/S0140-6736(94)90170-8","article-title":"Cerebral palsy in preterm infants.","volume":"343","author":"Allan","year":"1994","journal-title":"Lancet"},{"key":"2025090515084870000_80.2.F115.5","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/S0140-6736(94)92984-X","article-title":"Survival and cerebral morbidity in preterm infants.","volume":"343","author":"Cooke","year":"1994","journal-title":"Lancet"},{"key":"2025090515084870000_80.2.F115.6","doi-asserted-by":"publisher","DOI":"10.1136\/adc.65.6.602"},{"key":"2025090515084870000_80.2.F115.7","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1136\/adc.69.3_Spec_No.295","article-title":"Annual audit of three year outcome in very low birthweight infants.","volume":"63","author":"Cooke","year":"1993","journal-title":"Arch Dis Child"},{"key":"2025090515084870000_80.2.F115.8","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/j.1651-2227.1984.tb09951.x","article-title":"The changing panorama of cerebral palsy in Sweden. IV. Epidemiological trends 1959-78.","volume":"73","author":"Hagberg","year":"1984","journal-title":"Acta Paediatr Scand"},{"key":"2025090515084870000_80.2.F115.9","doi-asserted-by":"publisher","DOI":"10.1136\/adc.62.4.379"},{"key":"2025090515084870000_80.2.F115.10","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1542\/peds.90.5.750","article-title":"Population based study of the incidence, complexity, and severity of neurologic disability among survivors weighing 500 through 1250 grams at birth: a comparison of two birth cohorts.","volume":"90","author":"Robertson","year":"1992","journal-title":"Pediatrics"},{"key":"2025090515084870000_80.2.F115.11","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1111\/j.1440-1754.1995.tb00856.x","article-title":"Changing patterns of survival and outcome at 4 years of children who weighed 500-999 g at birth.","volume":"31","author":"Tudehope","year":"1995","journal-title":"J Paediatr Child Health"},{"key":"2025090515084870000_80.2.F115.12","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1515\/jpme.1995.23.5.395","article-title":"Changing pattern of cerebral palsy. Declining trend for incidence of cerebral palsy in the 20-year period 1970-89.","volume":"23","author":"Meberg","year":"1995","journal-title":"J Perinatal Med"},{"key":"2025090515084870000_80.2.F115.13","doi-asserted-by":"publisher","DOI":"10.1542\/peds.101.4.642"},{"key":"2025090515084870000_80.2.F115.14","unstructured":"Freud S (1897) Infantile Cerebrallahumung. Nothnagel\u00e2\u0080\u0099s Specielle Pathologie und Therapie. (Vol 12) (A Holder, Vienna)."},{"key":"2025090515084870000_80.2.F115.15","doi-asserted-by":"publisher","DOI":"10.1136\/adc.65.2.201"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fn.80.2.F115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T22:41:58Z","timestamp":1757112118000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/fn.80.2.F115"}},"subtitle":["This study was presented at the Second Spring Scientific Meeting of The Royal College of Paediatrics and Child Health, York, April 1998"],"short-title":[],"issued":{"date-parts":[[1999,3,1]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1999,3,1]]},"published-print":{"date-parts":[[1999,3,1]]}},"alternative-id":["10.1136\/fn.80.2.F115"],"URL":"https:\/\/doi.org\/10.1136\/fn.80.2.f115","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,3,1]]}}}