Neurodevelopmental Follow-Up at Five Years Corrected Age of Extremely Low Birth Weight Infants after Postnatal Replacement of 17β-Estradiol and Progesterone

Context: Extremely low birth weight (ELBW) infants are prone to impaired neurodevelopment. Objective: The aim was to determine long-term neurodevelopmental outcome in ELBW infants after postnatal 17 beta-estradiol (E2) and progesterone (P) replacement. Design: At 5-yr corrected age, ELBW infants were assessed for standardized cognitive and neurological outcome after postnatal randomized E2 and P replacement or placebo administration. Setting: The follow-up examination was performed in a neuropediatric ambulatory care center. Patients: Sixty-one of 71 surviving infants (86%) were available for follow-up. Main Outcome Measures: Cognitive and neurological outcome was evaluated using the Kaufmann Assessment Battery for Children, the Gross Motor Function Classification Scale, and clinical neurological examination. Results: No significant differences were found between the replacement and placebo groups for the Gross Motor Function Classification Scale, presence of paresis, cerebral palsy, spasticity, and ametropia. However, a significant time-response relationship was found with E2 and P replacement. Every day of treatment reduced the risk for cerebral palsy (P = 0.03), spasticity (P = 0.01), and ametropia (P = 0.01). Conclusion: Postnatal E2 and P replacementmayhave potential in improving neurodevelopmental outcome in ELBW infants. Larger trials are needed to test this new hypothesis. (J Clin Endocrinol Metab 97: 1041-1047, 2012)