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Extremely low-birth-weight infants less than 901 g. Growth and development after one year of life
K Stjernqvist1, N W Svenningsen
1Department of Paediatrics, University Hospital, Lund, Sweden.
Insights
Extremely low-birth-weight infants often show normal development by one year, despite some delays. Further follow-up is needed to confirm favorable long-term outcomes for these high-risk infants.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Perinatal Medicine
Background:
- Extremely low-birth-weight (ELBW) infants face significant risks for morbidity and developmental challenges.
- Long-term outcomes for ELBW infants require comprehensive assessment beyond the neonatal intensive care unit (NICU) stay.
Purpose of the Study:
- To compare the growth, development, and ongoing morbidity of ELBW infants with full-term infants at one year of age.
- To evaluate the neurological status, specific morbidities (hydrocephalus, retinopathy), and hospital readmission rates in ELBW survivors.
Main Methods:
- A prospective control study comparing 20 ELBW infants (500-900g birth weight, 24-30 weeks gestational age) with 20 full-term infants.
- Assessment of growth, neurodevelopment, neurological abnormalities, retinopathy of prematurity, and hospital readmissions up to one year post-discharge.
Main Results:
- 17% of ELBW infants had neurological abnormalities; 8.7% required shunt for hydrocephalus; 13% had retinopathy of prematurity with vision deficit.
- Hospital readmission rate was 70%, primarily for respiratory infections in infants with chronic lung disorders.
- 80% of ELBW infants demonstrated normal development at one year, though some showed delays compared to controls.
Conclusions:
- While ELBW infants experience significant morbidities, many achieve normal cognitive development by one year.
- Results suggest a potentially favorable long-term outlook for many ELBW survivors, warranting continued follow-up.
- Early intervention and ongoing monitoring are crucial for optimizing outcomes in this vulnerable population.
Abstract:
In a long-term prospective control study, 20 extremely low-birth-weight infants with birth weights between 500 and 900 g (mean 755 +/- 109 g) and gestational ages between 24 and 30 weeks (mean 26.2 +/- 1.8 weeks) were compared with 20 full-term infants, after the first year of life for growth, development and continuing morbidity after discharge from the intensive care unit. The total rate of neurological abnormalities was 17%; the rate of infantile post-hemorrhagic hydrocephalus requiring shunt operations was 8.7%, while 13% had retinopathy of prematurity with vision deficit, but none was blind. The hospital readmission rate was 70%, but for most infants only one or a few readmissions were needed whereas three infants with chronic lung disorders required frequent hospital readmissions, mainly for respiratory infections. Apart from 4 infants with major cerebral neonatal complications, 16 of 20 extremely low-birth-weight infants (80%) showed development within the normal range at one year of age, although with delay in some areas in comparison with full-term control infants. Follow-up into preschool and school age is in progress. We cautiously suggest that the results at the one year follow-up do indicate a possible favourable long-term outcome for many of these extremely low-birth-weight infants with normal cognitive development and with no major neurological sequelae.