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Growth and development of infants weighing less than 800 grams at birth
Insights
Most extremely low birth weight infants who survive intensive care show positive neurodevelopmental outcomes. Despite common complications, 81% of survivors had no major central nervous system handicaps, indicating hopeful prognoses.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Perinatal Research
Background:
- High neonatal mortality rates affect infants with extremely low birth weight (ELBW).
- Neurodevelopmental outcomes in ELBW survivors require ongoing assessment.
- Early intensive care practices influence ELBW infant prognoses.
Purpose of the Study:
- To evaluate the neurodevelopmental outcomes of ELBW infants.
- To identify factors associated with survival and healthy development in ELBW infants.
- To assess the long-term impact of neonatal intensive care on ELBW survivors.
Main Methods:
- Prospective study of infants weighing less than 800g.
- Neurodevelopmental assessment of survivors at 6 months to 3 years of age.
- Analysis of perinatal factors and their relation to outcome.
Main Results:
- Neonatal mortality was 80%; 18 infants survived.
- Of 16 survivors assessed, 13 (81%) had no major central nervous system (CNS) handicaps.
- Apgar scores were significantly related to outcome, while apnea and mechanical ventilation were not.
Conclusions:
- Remarkably hopeful neurodevelopmental outcomes are achievable for ELBW survivors.
- Early intensive care can lead to positive long-term development despite significant perinatal challenges.
- ELBW infants surviving intensive care demonstrate resilience and potential for appropriate development.
Abstract:
A prospective study of infants weighing less than 800 g at birth and cared for in a single neonatal intensive care unit between 1977 and 1980 was conducted. Neonatal mortality was 80%; neurodevelopmental outcome was assessed in 16 of the 18 survivors. Mean birth weight for these 16 was 730 g; mean gestational age was 26 weeks. Perinatal asphyxia, respiratory distress, apnea, mechanical ventilation, and chronic pulmonary disease were commonplace. Symptomatic intracranial hemorrhage, seizures, sepsis, or meningitis did not occur in survivors. Of the 16 infants, 13 (81%), including all three with birth weight less than 700 g, were without major CNS handicaps and were developing appropriately at 6 months to 3 years of age. Only one of the 16 had clearly subnormal mental development. None had a major visual or hearing impairment. Apgar scores at one and five minutes were significantly related to outcome; apnea, mechanical ventilation, and chronic pulmonary disease were not. These data suggest that a remarkably hopeful outcome is possible for the few survivors of extremely low birth weight.