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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental outcome at age two years amongst very low birth weight infants: results from a district general
1Department of Community Paediatrics, Rotherham Priority Health Trust, South Yorkshire.
Insights
Most very low birth weight infants survived and had normal neurodevelopment at age 2 years. Routinely collected data effectively tracked survival and neurodevelopmental outcomes in these vulnerable infants.
Area of Science:
- Neonatal care and developmental pediatrics.
- Public health and epidemiology.
Background:
- Very low birth weight (VLBW) infants (<1,501 g) require specialized care.
- Assessing long-term neurodevelopmental outcomes is crucial for VLBW infants.
Purpose of the Study:
- To evaluate survival and neurodevelopmental outcomes at age 2 years for VLBW infants.
- To assess the utility of routinely collected data for outcome measurement.
- To compare findings with existing literature.
Main Methods:
- Retrospective case note review and child health surveillance.
- Inclusion of all liveborn VLBW infants (1989-1992) from a district general hospital.
- Assessment of outcomes: mortality, normal neurodevelopment, minor impairment, and major impairment at 2 years.
Main Results:
- 125 VLBW infants were identified; 74% survived to discharge.
- Neurodevelopmental data at 2 years was available for 92 infants.
- 70% had normal neurodevelopment, 11% had major impairment (e.g., cerebral palsy), and 19% had minor impairment.
Conclusions:
- Neurodevelopmental outcomes for VLBW infants in a district general hospital setting are comparable to published series.
- Routinely collected clinical information can provide valuable outcome data.
- Standardized outcome measures are needed for robust inter-unit comparisons due to confounding variables.
Study Objectives:
To describe the survival and neurodevelopmental outcome at age 2 years of very low birth weight infants from routinely collected information in a district general hospital setting.
Design:
Case note review and child health surveillance information was collected on all liveborn < 1,501 g infants born in our district general hospital over 4 years, 1989-1992. Main outcome measures were (a) death before discharge, (b) normal neurodevelopment at age 2 years, (c) minor impairment at age 2 years, (d) major impairment at age 2 years. Comparability with other published work was examined.
Setting:
Rotherham District General Hospital, a maternity unit with neonatal intensive care facilities. Selected infants were transferred for continuing neonatal intensive care to a tertiary unit. Most infants were followed up to age 2 years in a dedicated clinic.
Subjects:
Liveborn very low birth weight infants.
Main Results:
Over the 4 year period there were 125 liveborn infants < 1,501 g; 93 (74%) survived to discharge home. Defined neurodevelopmental outcome measures were easily retrievable in 92 children at age 2 years from hospital case notes or child health surveillance records. Sixty-four children (70%) were neurodevelopmentally normal, 10 children (11%) had a major impairment (mostly cerebral palsy) and 18 (19%) had an isolated minor impairment.
Conclusions:
The incidence of major impairment amongst very low birth weight infants in our district general unit is broadly comparable with other published series. Outcome measures of neurodevelopmental status are available from routinely collected clinical information. The use of such measures to make detailed comparisons between units is problematical because of a wide range of confounding variables.
