Late-Onset Circulatory Collapse and Risk of Cerebral Palsy in Extremely Preterm Infants

Objective To investigate whether the development of postnatal, late-onset refractory hypotension, referred to as late-onset circulatory collapse, was associated with an increased risk of developing cerebral palsy (CP) at 3 years of age in extremely preterm infants. Methods In this historical cohort study, infants who were born at 22-27 weeks of gestation from 2008 to 2012 in the Neonatal Research Network of Japan were eligible. The study sample consisted of 3474 infants (45.6% of 7613 potentially eligible infants) who were evaluated at 36-42 months of age. Late-onset circulatory collapsewas defined as a clinical diagnosis of late-onset circulatory collapserequiring treatment with corticosteroids. We compared the neurodevelopmental outcomes between infants with and without late-onset circulatory collapse. Results Late-onset circulatory collapsewas diagnosed in 666 of the infants studied. Infants with late-onset circulatory collapsehad a higher incidence of CP than those without late-onset circulatory collapse(18.0% vs 9.8%; P Conclusions Late-onset circulatory collapsemay be a relatively common event occurring in extremely preterm infants and an independent risk factor for CP at 3 years of age.