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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Growth and neurodevelopmental outcomes of extremely low birth weight infants: a single center's experience
Yung-Chieh Lin1, Yuh-Jyh Lin, Chyi-Her Lin
1Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
Insights
Extremely low birth weight (ELBW) infants show significant growth and developmental delays by age 2. Male ELBW infants and those under 750g face higher risks, highlighting the need for comprehensive follow-up care.
Area of Science:
- Neonatalogy
- Pediatric Development
- Public Health
Background:
- Improved survival rates for extremely low birth weight (ELBW) infants in Taiwan.
- Limited data on post-discharge anthropometry and development in ELBW infants.
Purpose of the Study:
- To evaluate the anthropometric measurements and neurodevelopmental outcomes of ELBW infants at 2 years corrected age.
- To identify risk factors for adverse outcomes in ELBW survivors.
Main Methods:
- Retrospective analysis of ELBW infants discharged from a tertiary care center (2004-2007).
- Follow-up to 2 years corrected age with anthropometry (BW, BL, HC) and Bayley Scales of Infant Development-II.
- Growth delay defined as parameters below the 10th percentile; abnormal development as an index < 70.
Main Results:
- High incidence of growth delay in weight, length, and head circumference across genders and ages.
- Significantly lower Bayley Scale scores in ELBW infants compared to the normal population.
- Male infants exhibited poorer neurodevelopmental outcomes; 61% of infants < 750g had mortality or impairment.
Conclusions:
- ELBW infants exhibit substantial growth and developmental delays by 2 years corrected age.
- Male infants and those with very low birth weight (<750g) are at increased risk.
- Effective pre-discharge planning and consistent post-discharge follow-up are crucial for ELBW survivors.
Background/Purpose:
The outcome of extremely low birth weight (ELBW, ≤1000 g) infants has recently been improved in Taiwan. However, their postdischarge anthropometry and development have seldom been explored. We report these results for ELBW infants at corrected age of 2 years in a tertiary care center.
Methods:
This descriptive and retrospective study enrolled ELBW infants discharged alive from a tertiary care center from January 2004 to December 2007. A scheduled follow-up program up to 2-year corrected age was tightly controlled by a case manager. Bayley Scales of Infant Development-Second Edition, representing the mean ± 1 standard deviation as 100 ± 15 in normal population, was used to assess infants' development. An index less than 70 was regarded as abnormal. Anthropometry, including body weight (BW), body length (BL), and head circumference (HC), against the growth standard from the World Health Organization was assessed. Growth delay was defined as growth parameters below the 10(th) percentile values.
Results:
One hundred ELBW infants were enrolled. Eighty of them were discharged alive (80% surviving), and their follow-up rates were 91% at 6 months, 90% at 12 months, and 83% at 24 months corrected ages. The 2-year survival rate was 75%. The percentages of delayed growth in BW/BL/HC, presented as (male vs. female), were (33/41/37 vs. 38/25/45) at 6 months, (31/31/50 vs. 41/22/37) at 12 months, and (39/36/54 vs. 26/29/38) at 24 months. The negative means of the Z score for BW/BL/HC in both genders indicated ELBW infants had significant growth delay compared with those of the normal population. The index of Bayley scales was significantly lower in ELBW infants than that in normal population at each age. Male infants had lower mental development index and psychomotor development index at 2 years than females. About 61% of those with BW less than 750 g died or had neurodevelopmental impairment.
Conclusion:
ELBW infants have a high incidence of growth and developmental delay at corrected age of 2 years, particularly in male infants or those with BW less than 750 g. This study reveals that ELBW infants require well predischarge planning and postdischarge follow-up.
