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[Morbidity at 2 years in infants with a birth weight of < 1,500 g]
N Hernández González1, S Salas Hernández, A García-Alix Pérez
1Servicio de Neonatología, Hospital Infantil La Paz, 28047 Madrid, España. drnatalio@yahoo.es
Insights
This study followed very low birth weight infants and found that less than a fifth experienced severe neurodevelopmental issues by age two. Subnormal head size and white matter disease were linked to poor neurological outcomes in these vulnerable infants.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Developmental Pediatrics
Context:
- Very low birth weight (VLBW) infants (<1,500 g) face significant risks for long-term morbidities.
- Early identification of neurodevelopmental impairments is crucial for timely intervention.
- This study examines outcomes in a cohort born between 1999-2000.
Purpose:
- To assess the prevalence of major neurodevelopmental sequelae at 2 years' corrected age in VLBW infants.
- To identify risk factors associated with poor neurological prognosis.
- To evaluate growth and developmental quotients in this cohort.
Summary:
- A cohort of 213 VLBW infants was followed, with 87% completing 2-year follow-up.
- 17.1% experienced one or more major sequelae, including cerebral palsy (5.8%), low development quotient (<85 in 14.9%), and failure to thrive (18% below 3rd percentile weight).
- Risk factors for poor neurological outcomes included subnormal head size and white matter disease on ultrasound.
Impact:
- Highlights the significant burden of neurodevelopmental disabilities in VLBW survivors.
- Identifies specific ultrasound markers (white matter disease) and clinical findings (head size) as predictors of adverse outcomes.
- Underscores the need for continued monitoring and support for growth and development in VLBW infants.
Objectives:
To determine morbidity at 2 years' corrected age in a cohort of neonates with a birth weight of less than 1,500 g born in 1999-2000 in a tertiary hospital in the Autonomous Community of Madrid.
Patients And Methods:
An observational longitudinal follow-up study was performed in a cohort of 213 infants with a birth weight of < 1,500 g. Of these, 188 (87%) completed the 2-year follow-up. Various types of neurosensorial disability were studied, paying special attention to the main impairments: vision, hearing and motor impairment, and low development quotient.
Results:
Among the patients initially included in the study, 87% completed the follow-up; 17.1% had one or more major sequela. We found one case (0.4%) of bilateral neurosensorial deafness and one case of bilateral blindness. At the age of 2 years, 5.8 % (11/188) had cerebral palsy, 14.9% had a development quotient below 85 and 18% had not reached the 3rd percentile for weight. Factors of poor neurological prognosis were subnormal head size at the age of 2 years and white matter disease (including persistent intraparenchymal periventricular echodensity and ventriculomegaly or irregular shape) as ultrasound findings.
Conclusions:
Less than a fifth of the very low birth weight infants presented severe sequelae at 2 years of follow-up. Factors of poor neurological prognosis were subnormal head size at 2 years and the presence of white matter disease on ultrasonography. The findings on growth and development were worrying, since 18 % of the patients had not reached the 3rd percentile for weight at 2 years' corrected age.
