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Neurodevelopmental and school performance of very low-birth-weight infants: a seven-year longitudinal study
Insights
Neurologic assessments at 1 year can predict developmental outcomes in very low-birth-weight infants up to age 7. Early classification helps identify children needing special education support.
Area of Science:
- Developmental Pediatrics
- Neonatology
- Child Neurology
Background:
- Very low-birth-weight (VLBW) infants face risks for neurodevelopmental challenges.
- Longitudinal tracking is crucial for understanding developmental trajectories in VLBW populations.
- Early identification of potential issues informs timely interventions.
Purpose of the Study:
- To examine the stability of neurologic functioning from 1 to 7 years in VLBW infants.
- To correlate early neurologic status with later developmental outcomes, including cognitive and academic performance.
- To assess the need for special educational services based on early neurologic classification.
Main Methods:
- A cohort of 42 VLBW infants (birth weight ≤ 1,500 g) born in 1975 was followed for 7 years.
- Infants were neurologically assessed at 1 year and classified as normal, suspect, or abnormal.
- Developmental assessments at 7 years included cognitive function (IQ), visual-motor integration, and academic achievement.
Main Results:
- Neurologic status at 7 years strongly correlated with the 1-year assessment; 77% of normal, 58% of suspect, and 100% of abnormal infants remained in their initial category.
- Infants initially classified as abnormal showed the most cognitive improvement but did not reach the IQ levels of the normal group.
- High rates of visual-motor integration deficits (45-100%) and reading difficulties (58-87%) were observed in suspect and abnormal groups.
- 54% of the total sample required special education, with significant differences across the initial neurologic groups (P < .05).
Conclusions:
- A neurologic assessment at 1 year is a valuable tool for predicting neurodevelopmental outcomes in VLBW infants up to age 7.
- Early classification aids in identifying children at risk for academic and developmental delays, guiding educational planning.
- This approach helps alert healthcare providers and educators to potential needs, facilitating early support for VLBW children.
Abstract:
The changing patterns of neurologic and developmental functioning between 1 and 7 years of age were studied in very low-birth-weight infants (birth weight less than or equal to 1,500 g). Subjects included 42 infants born in 1975 who were followed for 7 years. Based on the 1-year neurologic assessment, 22 infants were classified as normal, 12 as suspect, and eight as abnormal. The three groups did not differ in birth weight, gestational age, sex, or Hollingshead socioeconomic status (SES) score. The neurologic findings at 7 years of age were significantly related to the neurologic examination findings at 1 year of age. Seventy-seven percent of the normal group, 58% of the suspect group, and 100% of the abnormal group remained in the same neurologic category at 7 years of age. Children in the abnormal group had the greatest improvement in cognitive functioning between 1 and 7 years of age but did not achieve the IQ level of children in the normal group. Forty-five percent of the normal group, 75% of the suspect group, and 100% of the abnormal group had poor visual-motor integration. Fifty-eight percent of the suspect group and 87% of the abnormal group were reading below age level. Of the total sample, 54% required special education or resource help at 7 years of age, and the three groups differed significantly in their need for a special educational plan (P less than .05). These data indicate that a neurologic classification at 1 year of age provides a guide for monitoring very low-birth-weight infants and can be helpful in alerting school personnel to potential needs.