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Neurological and developmental disabilities in ELBW and VLBW: follow-up at 2 years of age
1Division of Follow-Up, Department of Neonatology, University of Medical Sciences, Poznan, Poland. stoinska@gpsk.am.poznan.pl
Insights
Neurodevelopmental disabilities are prevalent in premature infants, with severe outcomes more common in extremely low birth weight (ELBW) infants compared to very low birth weight (VLBW) infants, posing a significant healthcare challenge.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Public health
Background:
- Premature infants, particularly those with extremely low birth weight (ELBW) and very low birth weight (VLBW), are at increased risk for neurodevelopmental disabilities.
- Understanding the prevalence and types of these disabilities is crucial for effective intervention and support.
Purpose of the Study:
- To determine the prevalence of neurodevelopmental disabilities in premature infants born in western Poland.
- To identify risk factors associated with these disabilities.
Main Methods:
- A cohort of 640 ELBW and 777 VLBW infants admitted to a tertiary care center in Poland between 1999 and 2003 was studied.
- At 2 years corrected age, neurosensory abnormalities, including cerebral palsy (CP), were assessed using the Bayley Scales of Infant Development II.
Main Results:
- A significant prevalence of neurodevelopmental abnormalities was observed, with 23.1% of children scoring below 70 on the Mental Developmental Index (MDI).
- Specific disabilities included cerebral palsy (16.7%), deafness/hearing loss (1.7%), blindness (4.8%), and epilepsy (3.1%).
- Severe intraventricular hemorrhage, periventricular leucomalacia, ventricular dilatation, and hydrocephalus were identified as key risk factors for neurological abnormalities.
Conclusions:
- Severe neurodevelopmental disabilities are more common in extremely low birth weight infants compared to very low birth weight infants.
- These findings highlight a persistent challenge for healthcare providers in managing the long-term outcomes of premature infants.
Objective:
To establish the prevalence of neurodevelopmental disabilities among premature infants born in western Poland.
Study Design:
From 1999 to 2003, 640 extremely low birth weight (ELBW) and 777 very low birth weight (VLBW) infants were admitted to the tertiary care center in Poland. Discharged home were 302 and 671 of them, respectively. At 2 years corrected age, 165 ELBW and 285 VLBW children were diagnosed with neurosensory abnormality including cerebral palsy (CP) and evaluated with Bayley Scales of Infant Development II.
Result:
Mental developmental index (MDI) score <70 was recorded in 104 children (23.1%). There were 75 (16.7%) cases of CP, 8 (1.7%) deafness/hearing loss, 22 (4.8%) blindness and 14 (3.1%) of epilepsy. Patients with abnormal neurosensory status had significantly lower MDI compared with those with normal development (83.8±9 vs 54.7±10). Severe intraventricular haemorrhage, periventricular leucomalacia, ventricular dilatation and hydrocephalus were the most important risk factors for neurologic abnormality.
Conclusion:
Severe disability is more common among ELBW compared with VLBW infants and remains a major challenge for health-care providers.
