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A 2-year prospective study of very low birthweight infants
R Litt1, D S Seidman, V Gross-Tsur
1Department of Neonatology, Bikur Holim Hospital, Jerusalem, Israel.
Insights
Very low birthweight (VLBW) infants without major disability showed cognitive abilities equivalent to full-term peers at two years. This study tracked VLBW infant outcomes and disability incidence.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Public Health
Background:
- Very low birthweight (VLBW) infants (<1,501g) face developmental challenges.
- Neonatal intensive care unit (NICU) outcomes vary based on facility resources.
- Long-term neurodevelopmental follow-up is crucial for VLBW populations.
Purpose of the Study:
- To determine the incidence of major disability in VLBW infants.
- To compare the 2-year neurodevelopmental outcomes of VLBW infants without major disability to a control group.
- To assess the effectiveness of community-based neonatal intensive care.
Main Methods:
- Prospective 2-year follow-up of 68 surviving VLBW infants born 1985-87.
- Inclusion of a control group of full-term small-for-gestational-age infants.
- Assessment of cognitive development using the Mental Development Index (MDI) of the Bayley Scales.
Main Results:
- Major disability identified in 16% (11/68) of VLBW infants.
- Neonatal mortality rate was 29.8% during the study period.
- No significant difference in mean MDI scores at 2 years between VLBW infants (97.7 ± 19.5) and controls (99.7 ± 17.0).
Conclusions:
- VLBW infants without major disability exhibit cognitive abilities comparable to full-term peers at two years of age.
- The incidence of major disability in this community-based NICU cohort is similar to large tertiary centers.
- Community hospitals with NICU facilities can achieve comparable outcomes for VLBW infants.
Abstract:
A prospective 2-year follow-up study was carried out on 68 of the 69 surviving very low birthweight (VLBW) infants (< 1,501 g) born in Bikur Holim Hospital in the years 1985-87. The aims were a) to determine the incidence of major disability, and b) to compare the 2-year outcome of VLBW infants without major disability with that of a control group of full-term small-for-gestational-age infants, using the Mental Development Index (MDI) of the Bayley Scales. Mean birthweight of the VLBW infants was 1,234 +/- 216 g and mean gestational age was 30.7 +/- 2.4 weeks. Their neonatal mortality during the study period was 29.8%. Major disability was diagnosed in 11/68 infants (16%). At age 2 years there was no significant difference between the mean MDI of the VLBW infants without major disability (97.7 +/- 19.5) and that of the controls (99.7 +/- 17.0). These data, representing the outcome of VLBW infants from a community-based hospital with neonatal intensive care facilities, are comparable in incidence of major disability with data of large tertiary centers. Cognitive ability of VLBW infants without major disability at age 2 years was equivalent to that of their full-term peers.