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Beware Observational Studies in Neonatal Practice—Reply
Arch Pediatr Adolesc Med. 2003;157:935.
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In reply
I thank Dr Willoughby for his comments and careful reading of our article.1 We did our best to control for multiple confounding variables. However, we concur with Dr Willoughby that there may have been other variables, such as precipitous delivery, that could not be controlled for and thus may have accounted for some of the variability in cystic periventricular leukomalacia (PVL). We agree that longer-term follow-up, looking for outcomes such as cerebral palsy, would be ideal. However, we disagree with Dr Willoughby's sentiment that cystic echolucencies are clinically unimportant. Cystic PVL has been associated with a substantial risk of later CP or motor delay.2-4 Thus, although some infants with cystic PVL may ultimately be free of later motor disability, cystic PVL remains a clinically significant marker of early brain injury. We would like to reemphasize that our data show an association between antenatal antibiotics and reduced risk of . . . [Full Text of this Article]
Mae M. Coleman, MD;
Kathleen H. Leef, RN;
Deborah Tuttle, MD;
John L. Stefano, MD
Newark, Del
David Paul, MD
Section of Neonatology
Christiana Care Health System
4755 Ogeltown-Stanton Rd
Newark, DE 19718
(e-mail: paul.d@christianacare.org)
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Beware Observational Studies in Neonatal Practice
Rodney E. Willoughby, Jr
Arch Pediatr Adolesc Med. 2003;157(9):934-935.
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