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[Growth and development of very-low-birth-weight infants]
1Neonatal Intensive Care Unit, Hadassah-University Hospital, Mount Scopus, Jerusalem.
Insights
Most very-low-birth-weight infants who survived hospitalization showed normal development by age two. Clinical course, neurological sequelae, and parent-infant relationship quality significantly impacted developmental outcomes.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Perinatal medicine
Context:
- Focuses on the long-term neurodevelopmental outcomes of very-low-birth-weight (VLBW) infants.
- Examines a cohort of VLBW infants born between 1983-1986.
- Assesses developmental status at 1-2 years of corrected age.
Purpose:
- To identify factors associated with neurodevelopmental outcomes in VLBW infants.
- To evaluate the relationship between clinical course, parental factors, and infant development.
- To determine the predictive value of various clinical and demographic variables on development.
Summary:
- A cohort of 291 VLBW infants was studied, with 178 surviving and 103 assessed at 1-2 years corrected age.
- 67% of assessed infants had normal development, 23.3% mild-moderate impairment, and 9.7% severe impairment.
- Clinical course, neurological sequelae, and parent-infant relationship quality were significant predictors of development.
Impact:
- Highlights the importance of clinical management during hospitalization for VLBW infants.
- Emphasizes the crucial role of the parent-infant relationship in promoting positive developmental trajectories.
- Suggests that interventions targeting modifiable factors can improve outcomes for VLBW survivors.
Abstract:
Of 291 very-low-birth-weight (less than 1,500 g) premature infants treated during the years 1983-6, 178 (61.2%) survived. Of these, 103 (57.9%) were reexamined between 1 and 2 years of corrected age. 67% were functioning at normal level, 23.3% were mildly to moderately affected, while 9.7% showed severe delay or handicap. Factors significantly associated with development were clinical course and neurological sequelae during hospitalization, and the quality of the parent-infant relationship. There was no significant association between development and sex, multiple gestation, birthweight relative to gestational age, socioeconomic status of family, and attendance at the follow-up clinic. Birth-weight was a significant factor correlated with development by the chi-square test but not by stepwise multiple regression analysis. Growth parameters (weight, length, and head circumference) were associated with birth-weight. Our ability to modify the factors associated with development may improve the outcome of very-low-birth-weight infants.