Outcomes at 18-24 Months of Infants with Birth Weight under 500 g Born in Korea during 2013-2017: A Nationwide Cohort
Soo Hyun Kim1, Euiseok Jung2, Ha Na Lee2
1Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea, soohyunkim06@gmail.com.
Insights
Half of extremely low birth weight infants in Korea experience neurodevelopmental impairment and growth issues by 24 months. Early intervention and multidisciplinary care are crucial for improving outcomes in these vulnerable infants.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Public Health
Background:
- Extremely low birth weight (ELBW) infants (<500 g) represent a high-risk population.
- Understanding their long-term neurodevelopmental outcomes is critical for targeted interventions.
Purpose of the Study:
- To investigate the neurodevelopmental and anthropometric outcomes of ELBW infants born in Korea.
- To identify the prevalence of impairments at 18-24 months corrected age.
Main Methods:
- Retrospective review of anthropometric and neurodevelopmental data.
- Infants born <500 g (gestational age ≥22 weeks) in the Korean Neonatal Network (2013-2017) were assessed at 18-24 months corrected age.
- Neurodevelopmental impairment included cerebral palsy, visual impairment, hearing impairment, and cognitive impairment.
Main Results:
- 50% of ELBW infants exhibited neurodevelopmental impairment at a median of 20 months corrected age.
- Cognitive impairment was most prevalent (57%), followed by cerebral palsy (22%).
- Significant growth retardation was observed in over 50% for weight, length, and head circumference; 70% required rehospitalization, often for respiratory issues.
Conclusions:
- ELBW infants in Korea face substantial risks of neurodevelopmental impairment and growth retardation.
- Multidisciplinary follow-up and continuous rehabilitation are essential for optimizing neurological and physical development.
- This highlights the need for specialized care pathways for this vulnerable infant population.
Introduction:
This study aimed to investigate the outcomes of infants at 18-24 months born in the Korean Neonatal Network with a birth weight <500 g.
Methods:
The anthropometric and neurodevelopmental data of infants with a birth weight <500 g at a gestational age of ≥22 weeks who were registered in the Korean Neonatal Network 2013-2017 and followed up at a corrected age of 18-24 months were reviewed. Neurodevelopmental impairment was defined as the presence of any of the following: (1) cerebral palsy; (2) severe visual impairment; (3) hearing impairment; or (4) cognitive impairment. Cognitive impairment was defined as (1) a Bayley Scales of Infant Development-II Mental Development Index score <70; and (2) Bayley Scales of Infant and Toddler Development-III Cognitive and Language Composite scores <85. Cognitive testing was performed for infants with suspected problems upon clinician's referral to developmental specialists.
Results:
At a median corrected age of 20 months, 26/52 (50%) of included infants had neurodevelopmental impairment. Cerebral palsy, severe visual impairment, wearing of glasses, hearing impairment, and cognitive impairment occurred in 22%, 0%, 8%, 5%, and 57% of the included infants, respectively. The proportions of infants with <2 standard deviations of weight, length, and head circumference were 54%, 52%, and 56%, respectively. The majority (70%) of infants were rehospitalized, and the most common cause was respiratory problems.
Conclusion:
Half of infants with a birth weight <500 g in Korea may exhibit neurodevelopmental impairment and growth retardation at a corrected age of 18-24 months. Multidisciplinary follow-up along with continuous rehabilitation will be needed to improve neurological and physical development in this special population.
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