Related Experiment Videos
Improving health status in extremely low birthweight children between two and five years
V Y Yu1, M L Manlapaz, J Tobin
1Department of Paediatrics, Monash Medical Centre, Melbourne, Victoria, Australia.
Insights
Extremely low birthweight (ELBW) children show improved health by age 5, but many still face neurodevelopmental issues and frequent hospital readmissions, impacting families.
Area of Science:
- Neonatal Intensive Care
- Pediatric Health Outcomes
- Developmental Pediatrics
Background:
- Extremely low birthweight (ELBW) infants (<1000g) require intensive neonatal care.
- Long-term health outcomes and developmental trajectories for ELBW survivors are critical areas of study.
Purpose of the Study:
- To report the 5-year health outcomes of ELBW children discharged from Neonatal Intensive Care Unit (NICU).
- To analyze neurodevelopmental impairment, hospital readmission rates, and specific health problems in ELBW survivors up to age 5.
Main Methods:
- A cohort of 101 ELBW children was followed for 5 years post-discharge.
- Data collected included mortality, neurodevelopmental assessments (cerebral palsy, blindness, deafness, developmental delay), and hospital readmission records.
Main Results:
- Four post-discharge deaths occurred. The overall neurodevelopmental impairment rate was 18%, with cerebral palsy (7%), blindness (3%), deafness (3%), and developmental delay (10%).
- Seventy-one percent of children were readmitted, averaging 2.4 admissions and 11.3 days of hospital stay per child over 5 years.
- Readmission rates and hospital days showed a non-significant trend of reduction between 2-5 years compared to the earlier period. Common reasons for readmission included surgical procedures (ventilation tubes, tonsillectomy).
- Significant health issues included recurrent respiratory problems (wheezing, stridor, croup) up to age 2, and otitis media and tonsillitis between ages 2-5. Catch-up growth, particularly in height, was observed.
- Children with birthweight <800g experienced similar neurodevelopmental impairment and readmission rates but had higher rates of otitis media, pneumonia, ENT surgeries, and were more likely to be below the 3rd weight percentile at age 5.
Conclusions:
- ELBW children demonstrate improved health status between 2 and 5 years.
- Despite improvements, ELBW survivors continue to experience recurrent health problems and hospital readmissions, posing financial and emotional burdens on families.
- Early identification and management of ongoing health issues in ELBW survivors are essential.
Abstract:
The 5-year outcome of 101 extremely low birthweight (ELBW, < 1000 g) children discharged from the Neonatal Intensive Care Unit was reported. Over this period, there were four post-discharge deaths. The neurodevelopmental impairment rate was 18% overall: cerebral palsy 7%, blindness 3%, deafness 3% and developmental delay 10%. Seventy-one percent of children were readmitted to hospital. The mean number of admissions was 2.4 per child and the mean duration of total hospital stay was 11.3 days per child in the 5-year period. A trend was observed in a reduction in the readmission rate and hospital days in the 2-5-year period compared to the period between discharge and 2 years, though the differences were not statistically significant. The most common reason for readmission was for surgical procedures, primarily aural ventilation tube insertion and tonsillectomy and adenoidectomy. Significant health problems included recurrent wheezing episodes, stridor and croup in the period up to 2 years and otitis media and tonsillitis between 2 and 5 years. There was some catch-up growth, especially in height, between 2 and 5 years. Children with < 800 g birthweight had similar rates of neurodevelopmental impairment and hospital readmission to those of 800-999 g birthweight. However, they experienced more otitis media and pneumonia, had more ear, nose and throat operations, and at 5 years of age, more were below the 3rd centile for weight. This study showed that the health status of ELBW children had improved between 2 and 5 years, but they continued to experience recurrent health problems and hospital readmissions which would have resulted in added financial and emotional burdens to their families.