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[Development of premature children below a birth weight of 1,500 g]
Insights
Survival rates for premature infants under 1,500g are significantly impacted by birth location. Infants born at a specialized obstetrics clinic showed better survival and neurodevelopmental outcomes compared to those born in peripheral hospitals.
Area of Science:
- Neonatalogy
- Pediatric Neurology
Context:
- This study analyzes data from 5,928 newborn infants admitted between 1974-1981.
- Focuses on 418 premature infants with birthweights < 1,500g.
Purpose:
- To evaluate survival rates and neurodevelopmental outcomes of very low birthweight infants.
- To determine the influence of birth location on outcomes for these infants.
Summary:
- Infants born below 1,000g had an 18% survival rate, with 67% being small for gestational age.
- Survival for infants between 1,000-1,500g was 71%, with 23% being dystrophic.
- Birth at a specialized obstetrics clinic significantly improved survival (24%) versus peripheral hospitals (3%).
- Of surviving infants, 13/14 with normal psychomotor development were born at the specialized clinic.
- Follow-up showed 43% normal development at 1 year, decreasing to 5% with psychomotor problems by age 3.
- Hemi-/diplegia and seizure activities were observed in some survivors.
Impact:
- Highlights the critical role of birth location and specialized care for very low birthweight infants.
- Emphasizes the importance of routine developmental assessment at 12 months for early diagnosis of permanent retardation.
- Provides insights into long-term neurodevelopmental outcomes, including motor deficits and epilepsy.
Abstract:
5,928 newborn infants were admitted between the years 1974 and 81 to the University of Innsbruck, Department of Pediatrics. 418 (7%) of them were premature infants with a birthweight of less than 1,500 g. 21 (18%) of the premature infants with a birthweight below 1,000 g survived (21 of 117). Among those 21 surviving infants only 7 (33%) had an appropriate birthweight, 14 (67%) were too small for their gestational age. Survival in the weight range between 1,000-1,500 g was 71% (213 of 301). The percentage of dystrophic infants was 23% (49 of 213). The place of birth has a significant influence on the survival of these very small immature infants. 24% (n = 84) of patients delivered in the nearby Clinic of Obstetrics survived in contrast to only 3% (n = 33) of those born in peripheral hospitals. This is reemphasized by the evaluation of psychomotor development of surviving infants; of 14 patients with normal psychomotor milestones 13 were delivered at our obstetric department. 157 patients were regularly followed up during their first year of life. 43% can be considered normal by all parameters. 57% show some abnormalities in their development during the first years of life. During their second year of life only 13% showed psychomotor problems and this number decreased to 5% in the third year. All these children show varying degrees of hemi- or diplegia and/or seizure activities. A routine check up at 12 month of life seems important as all patients with permanent retardation can be correctly diagnosed at this age.(ABSTRACT TRUNCATED AT 250 WORDS)