SEVERITY OF ABRUPTIO PLACENTAE AND NEURODEVELOPMENTAL OUTCOME IN LOW-BIRTH-WEIGHT INFANTS

The short term neonatal morbidity and 2-year neurodevelopmental outcom e were evaluated in 40 low birthweight (<2500 g) liveborn infants deli vered after abruptio placentae and in 80 control infants of similar ge stational age. Apgar scores at 1' and 5' were lower in infants born to mothers with severe abruption. The prevalence of intraventricular hem orrhage (Grades I-IV) was 17.5% (7/40) in the cases and 5% (4/80) in t he controls (P = 0.035). Cystic periventricular leucomalacia was diagn osed in two cases (5%) and in none of the controls (P = 0.1). At 2-yea r follow-up, among surviving infants, cerebral palsy (spastic diplegia , hemiplegia or tetraplegia with or without mental retardation) was di agnosed in 11.1% (4/36) of the cases and in none of the 76 controls (P = 0.011). After adjustment by logistic regression analysis for the ef fect of confounders (gestational age, birthweight, social class and du ration of mother's education) the odds ratio of a poor outcome defined as neonatal death or cerebral palsy was 4.4 (95% confidence interval, 1.2-17.0) in index cases as a whole and 8.0 (95% confidence interval, 1.5 to 43.0) in the subgroup of infants born after severe abruption. Mild abruption did not affect the 2-year infant outcome in both univar iate and multivariate analysis.