Neurodevelopmental Outcomes Clinical Trial
Official title:
Neurodevelopmental Outcomes and Quality of Life and Fluconazole Prophylaxis
The purpose of this study is to compare the neurodevelopmental outcome and quality of life between the fluconazole-treated and the placebo-treated patients that were enrolled in a fluconazole prophylaxis study that occurred in the investigators' neonatal intensive care unit (NICU) between 1998-2000.
Invasive fungal infections in preterm infants is associated with significant morbidity and
mortality. Mortality in infected infants < 1000 grams is between 26-66% and
neurodevelopmental impairment occurs in 57%.1-13 Between 1998-2000 we conducted a randomized
placebo controlled trial of fluconazole prophylaxis in 100 infants <1000 grams at
birth(IRB-HSR #9389). Invasive fungal infections occurred in none of the fluconazole-treated
patients compared to 20% of the placebo group. Following this study the efficacy has been
confirmed in a multicenter randomized controlled trial and 7 retrospective studies. One
major issue that has remained is whether the fluconazole-treated infants have better
neurodevelopmental outcomes as well as if it is safe without an increase in
neurodevelopmental impairment.
Neurodevelopmental outcomes can be assessed by testing and examinations or by parental and
child questionnaires. In addition, quality of life is an important context of outcomes.
Recent conceptualizations of quality of life recognize the multidimensional nature of
quality of life, including psychological and social functioning, consistent with the World
Health Organization's definition of health as "not only the absence of disease and
infirmity, but the presence of physical, mental, and social well-being." The World Health
Organization subsequently emphasized the growing consensus that quality of life is a
subjective experience, defined as "individuals' perceptions of their position in life in the
context of the culture and value systems in which they live, and in relation to their goals,
expectations, standards, and concerns."
To address these issues, we aim to study and compare the neurodevelopmental outcome and
quality of life between our fluconazole-treated and placebo-treated patients in our initial
study
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Time Perspective: Prospective
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