Related Experiment Videos
Outcome at 14 years of extremely low birthweight infants: a regional study
Insights
Extremely low birthweight (ELBW) children face significantly higher rates of neurosensory impairments and disabilities by age 14 compared to normal birthweight (NBW) peers. Early childhood assessments accurately predict later disability in ELBW survivors.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Public Health
Background:
- Extremely low birthweight (ELBW) survivors face long-term neurodevelopmental challenges.
- Understanding the long-term neurosensory outcomes and disabilities in ELBW children is crucial for effective intervention and support.
- Comparing ELBW outcomes to normal birthweight (NBW) controls provides essential context for prognosis.
Purpose of the Study:
- To assess neurosensory outcomes at 14 years in a cohort of ELBW children.
- To compare the prognosis of ELBW children with NBW controls.
- To evaluate the predictive value of early childhood assessments for later disability in ELBW survivors.
Main Methods:
- A geographically determined cohort study was conducted in Victoria, Australia.
- Consecutive ELBW survivors (birth weight 500-999g) born 1979-1980 were assessed at 14 years, alongside randomly selected NBW controls.
- Neurosensory impairments and disabilities were evaluated at 14 years and earlier in childhood.
Main Results:
- Of 79 ELBW children assessed at 14 years, 10% had cerebral palsy, 6% bilateral blindness, 5% deafness, and 46% had an IQ below -1 SD compared to NBW controls.
- Overall, 14% of ELBW children had severe, 15% moderate, and 25% mild disabilities, versus only 2% severe and 14% mild in NBW controls.
- Early childhood assessments (at 2, 5, and 8 years) were highly predictive of 14-year disability, with accuracy increasing with age.
Conclusions:
- ELBW children exhibit substantially higher rates of neurosensory impairments and disabilities at 14 years compared to NBW controls.
- Using NBW controls for comparison minimizes bias in assessing disability in ELBW children.
- Early childhood developmental assessments are strong predictors of long-term disability in ELBW survivors.
Objectives:
To determine the neurosensory outcome at 14 years of age of a regional cohort of extremely low birthweight (ELBW) children, to contrast their prognosis with normal birthweight (NBW) controls, and to determine the predictive value of assessments earlier in childhood.
Design:
Geographically determined cohort study.
Setting:
The state of Victoria, Australia.
Patients:
Consecutive ELBW survivors of birth weight 500-999 g (n = 88) born during 1979-1980, and 60 randomly selected contemporaneous NBW (birth weight > 2499 g) controls.
Main Outcome Measures:
Rates of neurosensory impairments and disabilities at 14 years of age, and earlier in childhood.
Results:
Of 351 ELBW consecutive live births, 88 (25%) survived and 79 (90%) of the survivors were assessed at 14 years of age. Of the 79 ELBW children assessed, eight (10%) had cerebral palsy, five (6%) had bilateral blindness, four (5%) were deaf requiring hearing aids, and 36 (46%) had an intelligence quotient (IQ) < -1 SD compared with the mean for the NBW controls. Overall 11 (14%) ELBW children were severely disabled, 12 (15%) were moderately disabled, 20 (25%) were mildly disabled, and 36 (46%) had no disability. In contrast, only one (2%) of 42 NBW children assessed had a severe disability, six (14%) had a mild disability, and the remaining 35 (83%) were not disabled. Comparing psychological test scores for ELBW children with those for NBW controls, rather than test norms, avoided bias in the assessment of disability earlier in childhood. Relative to assessments earlier in childhood, the prediction of disability at 14 years of age was highly significant at each of 2, 5, and 8 years of age, but the accuracy progressively increased with age.
Conclusions:
ELBW children have substantially higher rates of neurosensory impairments and disabilities at 14 years of age than NBW controls. Comparison of ELBW children with NBW controls avoids bias in the assessment of disability. Early childhood assessments are highly predictive of disability at 14 years of age.