Related Experiment Videos
Follow-up studies of very low birth weight infants (1,250 grams or less) born and treated within a perinatal center
Insights
Very low birth weight infants born in a perinatal center showed reduced rates of respiratory distress and major handicaps. Appropriate for gestational age infants experienced particularly favorable outcomes.
Area of Science:
- Neonatalogy
- Pediatric Development
- Perinatal Medicine
Background:
- Very low birth weight (VLBW) infants face significant risks, including respiratory distress and developmental challenges.
- Optimizing perinatal care is crucial for improving outcomes in high-risk newborns.
- Previous data on long-term development in VLBW infants treated in specialized centers is essential for evaluating care improvements.
Purpose of the Study:
- To evaluate the growth and neurodevelopmental outcomes of very low birth weight infants born between 1974 and 1977.
- To assess the impact of perinatal center care on the incidence of major handicaps in VLBW survivors.
- To compare outcomes between small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) VLBW infants.
Main Methods:
- Retrospective evaluation of 50 survivors from 132 VLBW infants (birth weight ≤1,250 gm).
- Assessment of birth weight, gestational age, Apgar scores, and incidence of respiratory distress syndrome.
- One-year follow-up included weight percentiles, neurological assessments, and developmental quotients (Gesell).
Main Results:
- 56% experienced respiratory distress syndrome, with 10% requiring mechanical ventilation.
- At one year, 46% of SGA infants and 8% of AGA infants were below the third percentile for weight.
- Major neurological abnormality or severe developmental delay occurred in 10% of infants; 30% of SGA infants and 8% of AGA infants had major handicaps.
Conclusions:
- Infants born and treated in a perinatal center demonstrated reduced incidence of asphyxia and severe respiratory distress syndrome.
- The overall incidence of major handicaps was reduced, particularly in appropriate-for-gestational age infants.
- Specialized perinatal care positively impacts neurodevelopmental outcomes for VLBW infants, especially AGA babies.
Abstract:
The growth and development of inborn very low birth weight infants was evaluated in 50 of 60 survivors from 132 babies weighing less than or equal to 1,250 gm born July 1974 to December 1977. Mean +/- SE birth weight and gestation was 1,066 +/- 19.3 gm and 29.5 +/- 0.3 weeks, respectively, with 13 infants small-for-gestational age. Of the survivors, 26% weighed less than or equal to 1,000 gm. Male to female ratio was 1:1.4. Apgar scores less than or equal to 5 at five minutes occurred in 16% of the infants. Respiratory distress syndrome occurred in 56%, but only 10% (5/50) required mechanical ventilation. At 1 year, 46% small for gestational age (SGA) and 8% appropriate for gestational age (AGA) infants were less than the third percentile for weight. Major neurologic abnormality occurred in three infants (6%), one of whom is also blind. Grade V retrolental fibroplasia occurred in two others. Severe developmental delay (development quotient < 80, Gesell) occurred in these five infants and two other neurologically normal babies. Of 15 infants weighing less than or equal to 1,000 gm, two had major handicaps. Eight percent of the AGA infants and 30% of the SGA infants had major handicaps. These data indicate that infants born and treated in a perinatal center have a decreased incidence of asphyxia and severe respiratory distress syndrome and that the incidence of major handicaps is reduced, especially in the appropriate for gestational age baby.