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Continuing morbidity in extremely low birthweight infants
Insights
Children born with extremely low birthweight (500-999g) experienced ongoing health issues, including high rehospitalization rates for respiratory problems and infections. However, those weighing 500-799g showed similar outcomes to 800-999g survivors, except for otitis media.
Area of Science:
- Neonatal Medicine
- Pediatric Health Outcomes
Background:
- Extremely low birthweight (ELBW) infants face significant health challenges post-discharge.
- Understanding long-term morbidity patterns is crucial for ELBW survivors.
Purpose of the Study:
- To assess the continuing morbidity in ELBW survivors up to 2 years of age.
- To compare health outcomes between ELBW infants weighing 500-799g and 800-999g at birth.
Main Methods:
- Longitudinal follow-up of ELBW survivors (500-999g) for 2 years post-discharge.
- Data collection on rehospitalizations, common medical disorders, growth parameters, and neurodevelopmental outcomes.
Main Results:
- 61% of ELBW survivors were rehospitalized, primarily for respiratory issues and surgical procedures.
- Common morbidities included otitis media (55%), wheezing (48%), and lower respiratory tract infections (29%).
- At 2 years, significant percentages were below the tenth percentile for weight (44%) and height (45%).
Conclusions:
- ELBW survivors require continuous comprehensive medical care and social support.
- Infants weighing 500-799g had comparable outcomes to those weighing 800-999g, barring higher rates of otitis media.
- Early and ongoing support is vital for improving long-term health trajectories in ELBW infants.
Abstract:
The pattern of lesser but continuing morbidity in the first 2 years was reported in 36 survivors who weighed 500-799 g at birth and in 83 survivors who weighed 800-999 g at birth. Over this period, there was one post-discharge death. Sixty-one percent of children were rehospitalized, most commonly for respiratory tract disorders and surgical procedures such as aural ventilation tube insertion and inguinal herniorrhaphy. Their three most common medical disorders were otitis media (55%), wheezing episode (48%) and lower respiratory tract infection (29%). At 2 years of age, 44% remained below the tenth percentile for weight, 45% for height and 12% for head circumference. Other lesser morbidity included iatrogenic scarring, abnormal head shape and behavioural problems. Except for otitis media, survivors of 500-799 g birthweight did not have a significantly higher rate of neurodevelopmental impairment, health problems, rehospitalization, suboptimal growth or behavioural disorders, compared to those of 800-999 g birthweight. This study confirms the need for providing extremely low birthweight children and their families with a continuity of comprehensive medical care and social support after hospital discharge.