Al28 Abstracts antenatally acquired injury, developmental anomaly, diagnosable metabolic disease or specific syndromes in this group of infants. 196 Neurodevelopmental follow-up of infants < 1200 g not admitted to the neonatal intensive care unit S DOMIZIO, M GUERRA, C AMERIO, D PACIOCCO, C SABATINO Neonatology and Neonatal Intensive Care Unit, University of Chieti, Italy Aim: To determine the neurodevelopmental and cogni- tive follow-up of infants with birth weight (BW) < 1200 g initially denied neonatal intensive care and to compare this with the outcome of those who received intensive care. Material and methods: The study cohort comprised all infants with BW < 1200g admitted to SS Annunziata Hospital between January 1992 and December 1996. The neonatal intensive care unit (NICU) group was admitted to the NICU within the first 48 h of life. The neonatal ward (NW) group was treated in a Level 2 nursery. A complete neurological assessment and Griffiths Mental Developmental Scales were carried out on the survivors at 24 months of age. Disability was defined as cerebral palsy (Cl’), sensorineural (SN) deafness or a general developmental score for chronological age of < 80. Results: The NW group (96) was significantly smaller than the NICU group (82) (mean BW 1002.9 g ZIS 1987.5 g, p =O.OOOl) and of lower gestational age (29.4 weeks vs 30.1 weeks p = 0.0302). The survival rate was much lower in the NW group (60.4% vs 80.5%, p =0.0004). A total of 124 of the 178 babies survived. Six died after discharge from hospital and three were excluded from follow-up for severe congenital abnormalities. Ninety-four infants (82%) were seen at 2 years of age, 42 (44.7%) were from NW group and 52 (55.3%) from the NICU group. Two children from the NW group were classified disabled (one with SN deafness and one with global develop- mental delay) whereas nine children in the NICU group were disabled (six with CP, two with SN deafness and normal motor development and six with global devel- opmental delay) (4.8% vs 17.3%, p=O.O60). The mean general developmental score did not differ significantly between the two groups: NW 89, SD 6 and NICU 84, SD 18.8, p=O.O876. The locomotor subscale quotient was significantly higher in the NW group (92 SD: 9.3 vs 85 SD: 21.6, p=O.O468). Disability in the NW group was associated with BW < 1OOOg while in the NICU group it was associated with bronchopulmonary dysplasia, severe intraventricular haemorrhage and periventricular leukomalacia. Conclusions: Cognitive outcome was not affected by elective refusal of admission to the NICU. Admission to the NICU resulted in a higher survival rate but at a price: more often than not these infants suffered from locomotor disabilities related to intraventricular haemor- rhage, periventricular leukomalacia and ventilatory complications such as bronchopulmonary dysplasia. 195 Positive rolandic sharp waves and periventricular leukomalacia S DOMIZIO, M GUERRA, G AMERIO, D PACIOCCO, G SABATINO Neonatal Intensive Care Unit, University of Chieti, Italy Purpose: The aim of this study is to delineate the relation between positive rolandic sharp waves (PRS) and periventricular leukomalacia (PVL). Material and methods: We evaluated 90 preterm infants less than 33 weeks of gestation who were admitted to Neonatal Intensive Care Unit of Chieti. The EEG was recorded for at least 30 min by means of bipolar montage using eight electrodes. We evaluated the EEG within 3 weeks of life. PRS were defined as sharp transients of positive polarity appearing in the rolandic regions, which were isolated and sharply differentiated from the background activities. The number of PRS/min was calculated over each record. When repeated EEG recordings were performed in an infant, the one with most frequent PRS was adopted. PRS were defined as being present when their frequency was beyond 0.2/min. PVL and its severity were diagnosed on the basis of ultrasonographic (US) findings during neonatal period and MRI findings during late infancy. Results: Thirty-one of the infants had PVL and developed spastic diplegia. US and MRI did not demonstrate any abnormal findings in the other 59 infants. None of them had spastic cerebral palsy. PRS were recognized in 12 infants with PVL group, although PRS were not observed in normal infants. PRS were observed in nine of 10 infants with severe PVL and in three of 11 infants with moderate PVL, but were not in any of ten infants with mild PVL. PRS appeared about 6 days after the back- ground EEG showed acute stage abnormalities and about 10 days before the appearance of cysts in the US and were associated with other chronic stage abnormalities. Conclusions: PRS are a specific marker of PVL but are not very sensitive. PRS are likely to be correlated with severe deep white matter injury because they are common in infants with severe PVL. 342 Inhibition of the activity of poly (ADP-ribose) synthase reduces ischaemic injury and inflammation in neonatal rat brain S DUCROCQ, M PLOTKINE, Y BEN-ARI, C CHARRIAUT-MARLANGUE INSERM U29 and Laboratoire de Pharmacologic de la Faculte’ des Sciences Pharmaceutiques et Biologiques, Paris, France Poly (ADP-ribose) synthase (PARS) an abundant nuclear protein has been described as an important candidate for mediation of neurotoxicity by nitric oxide. However, in cerebral ischaemia, excessive PARS activation may lead to energy depletion and exacerbation of neuronal damage. We examined the effect of inhibiting PARS on 1) the degree of cerebral injury, 2) the process of