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Development of very low birth weight infants: a regional study of 371 survivors
N Veelken1, K Stollhoff, M Claussen
1Department of Paediatrics, University Hospital Hamburg, Federal Republic of Germany.
Insights
Very low birth weight infants show high rates of neurological and developmental abnormalities. Early detection and intervention are crucial for improving outcomes in these high-risk children.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Neurology
Background:
- Infants with very low birth weight (VLBW) face increased risks for adverse neurodevelopmental outcomes.
- Long-term follow-up is essential to understand the spectrum of disabilities in this vulnerable population.
Purpose of the Study:
- To assess the neurological and developmental status of VLBW infants at corrected age of 18-20 months.
- To determine the prevalence of major and minor handicaps in this cohort.
Main Methods:
- Re-examination of 371 VLBW infants (birth weight < 1501 g) from Hamburg neonatal intensive care units.
- Neurological examination and Griffith Developmental Scale evaluation at 18-20 months corrected age.
Main Results:
- High rates of abnormalities observed: 14.8% cerebral palsy, 11% minor neurological deviations.
- Developmental delays noted in 8% (moderate) and 5% (severe) of children.
- 1.5% blindness due to retrolental fibroplasia; 5% isolated speech delay.
- Overall, 18.9% major and 23.5% minor handicaps identified.
Conclusions:
- VLBW infants exhibit a significant burden of neurodevelopmental impairments.
- Comprehensive neurodevelopmental assessment is critical for identifying handicaps in VLBW survivors.
- Findings underscore the need for specialized care and early intervention strategies for VLBW infants.
Abstract:
We re-examined 371 infants with birth weights less than 1501 g at a corrected age of 18-20 months. This sample amounted to 91% of such infants admitted to one of the six neonatal intensive care units in Hamburg between July 1983 and 1986. The neurological examination and a developmental evaluation using the Griffith Developmental Scale revealed higher rates of abnormalities than in most other studies. Fifty-five children (14.8%) suffered from cerebral palsy, classified in 45 as spastic diplegia, in 5 as spastic tetraplegia, in 1 as spastic hemiplegia and in 4 as dystonia. Of the children, 41 (11%) showed minor neurological deviations (hyperactivity, clumsiness, intention tremor). The development of 30 children (8%) without neurological abnormalities was moderately retarded (DQ 80-89, corrected for gestational age [GA]). Nineteen children (5%) were severely retarded (DQ less than 80, corrected for GA) and four children (1.5%) were blind due to retrolental fibroplasia. An isolated delay of speech development was found in 5 children. Seventy children (18.9%) had a major and 87 children (23.5%) a minor handicap.