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Neurodevelopmental outcome of very low birth weight babies admitted to a Malaysian nursery
Insights
Neurodevelopmental handicap in very low birth weight (VLBW) infants in Malaysia showed overall rates similar to developed nations. However, the proportion of VLBW survivors with moderate to severe handicap was notably low.
Area of Science:
- Neonatal care and developmental pediatrics.
- Public health and epidemiology of infant development.
Background:
- Very low birth weight (VLBW) infants face increased risks of neurodevelopmental challenges.
- Understanding the prevalence and patterns of handicap in VLBW survivors is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence and characteristics of neurodevelopmental handicap at two years of age in VLBW infants.
- To compare outcomes in a Malaysian cohort with international data.
Main Methods:
- Prospective enrollment of VLBW infants admitted to a Malaysian level 3 nursery in 1993.
- Developmental assessment using Griffiths mental scales at two years corrected age.
- Neurological, auditory, and visual assessments to grade functional handicap; control group comparison.
Main Results:
- Of 150 VLBW infants admitted, 82 survived to two years, with 77 assessed.
- Study group had a lower mean General Quotient (GQ) compared to controls (94 vs 104).
- 27.3% of VLBW survivors had a GQ 1+ SD below the mean; 23.3% exhibited mild to severe functional handicap.
Conclusions:
- Despite low survival rates, the overall functional handicap prevalence in Malaysian VLBW infants was comparable to developed countries.
- The proportion of VLBW survivors experiencing moderate or severe neurodevelopmental handicap was low in this cohort.
Objective:
To examine the prevalence and pattern of neurodevelopmental handicap at 2 years of age in very low birth weight infants (VLBW) admitted in 1993 to a level 3 Malaysian nursery.
Methods:
All VLBW babies born in the hospital or referred for neonatal care during 1993 were enrolled prospectively in the study. At 2 years of age development was assessed using the Griffiths mental scales. Neurological, hearing and visual assessments were graded into five groups according to functional handicap. Control infants were randomly selected during attendance at a primary health care clinic.
Results:
One hundred and fifty VLBW infants were admitted and 82 (54.6%) survived to 2 years, of whom 77 (93.9%) were assessed. The mean General Quotient (GQ) on the Griffiths Scales was 94 (15.7) for the study group and 104 (8.3) for the 60 controls. For GQ, 21 (27.3%) of the study population were 1 or more SD below the mean (18 between 1 and 2 SD and 3 > 2 SD) compared with 1 (1.6%) of the controls who was 1-2 SD below the mean. Visual impairment occurred in 2 study infants and none of the controls. There was no hearing impairment in either group. Cerebral palsy occurred in 3 (1 mild and 2 moderate-severe) of the study group and none of the controls. Functionally 18 (23.3%) of the study group had mild handicap, 1 (1.3%) moderate, 2 (2.5%) severe, 2 (2.5%) multiply severe and 54 (70.2%) were normal.
Conclusion:
Although survival was low, overall rates of functional handicap were similar to those reported in developed countries but the proportion with moderate or severe handicap was low.