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Nonhandicapped very-low-birth-weight infants at one year of age: developmental profile
W D Williamson1, G S Wilson, M H Lifschitz
1Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
Insights
Very-low-birth-weight infants show developmental differences compared to term infants. Comprehensive assessments are crucial for understanding their unique developmental profiles.
Area of Science:
- Neonatal development
- Pediatric neurodevelopment
Background:
- Very-low-birth-weight (VLBW) infants represent a high-risk group for developmental challenges.
- Previous studies often relied on global scores, potentially masking specific developmental deficits.
Purpose of the Study:
- To compare the developmental profiles of VLBW infants and term infants at 1 year of age.
- To identify specific areas of developmental discrepancy in VLBW infants.
- To highlight the need for comprehensive developmental assessments in VLBW populations.
Main Methods:
- A cohort of 61 VLBW infants without major deficits was compared to 28 term infants.
- The Revised Gesell Developmental Schedules were used for assessment at 1 year chronologic age.
- Correlations between medical factors and developmental outcomes were analyzed.
Main Results:
- VLBW infants exhibited significant discrepancies between fine motor/language skills and problem-solving abilities.
- Across all assessed domains (adaptive, motor, language, social), VLBW infants scored lower than term infants.
- Motor and language performance in VLBW infants correlated with factors like bronchopulmonary dysplasia, intracranial hemorrhage, and birth weight.
Conclusions:
- Global developmental scores are insufficient for accurately profiling VLBW infants.
- A comprehensive assessment across all behavioral domains is essential for VLBW infants.
- Early identification of specific developmental patterns is critical for targeted interventions.
Abstract:
The developmental profile of 61 very-low-birth-weight infants without major cognitive, motor, or sensory deficits was compared with that of 28 term infants at 1 year chronologic age. The groups significantly differed in two ways on the Revised Gesell Developmental Schedules. First, very-low-birth-weight infants were more likely than term infants to have significant discrepancies between either their fine motor or language abilities and their early problem-solving skills as measured by the Adaptive scale of the Gesell. Second, across all fields of behavior (adaptive, gross motor, fine motor, language, and personal/social), very-low-birth-weight infants scored significantly below term infants. The very-low-birth-weight infant's motor performance significantly correlated with bronchopulmonary dysplasia, intracranial hemorrhage, and number of days spent in the hospital. Language performance significantly correlated with intracranial hemorrhage, birth weight, and sex. These findings underscore the limitations of global developmental scores to describe adequately the developmental performance of very-low-birth-weight infants. Instead, a comprehensive assessment of all fields of behavior is necessary to provide an accurate profile of this high-risk group.