Related Experiment Video
Updated: Aug 15, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neuropsychological and functional outcomes of very low birth weight infants
1Women and Infants' Hospital, Child Development Center of Rhode Island Hospital, Brown University School of Medicine, Providence 02905, USA.
Insights
Advances in neonatal care improve survival for extremely low birth weight (ELBW) infants. While major disabilities remain stable, functional limitations and special education needs are increasing, requiring ongoing vigilance and comprehensive support strategies.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Public Health
Background:
- Improved perinatal and neonatal management has increased survival rates for extremely low birth weight (ELBW) infants.
- Comprehensive outcome assessment is crucial for evaluating interventions, informing policy, and guiding care for ELBW infants and their families.
- Survival rates for very low birth weight (VLBW) infants (< 800 g) have significantly improved over decades.
Purpose of the Study:
- To evaluate the outcomes of surviving ELBW infants across multiple developmental domains.
- To identify trends in functional limitations and special education needs among VLBW survivors.
- To advocate for comprehensive strategies optimizing long-term outcomes for infants at the limits of viability.
Main Methods:
- Longitudinal assessment of ELBW infants across neurologic, cognitive, visual, speech, motor, and functional skill domains.
- Analysis of survival rates and rates of major disabilities (cerebral palsy, mental retardation, blindness, deafness) in VLBW infants.
- Evaluation of the need for Special Education Resources among VLBW survivors.
Main Results:
- While rates of major disabilities like cerebral palsy and blindness have remained stable, there is evidence suggesting an increase in functional limitations.
- A significant proportion of VLBW infants (44%–56%) require Special Education Resources.
- Improved survival rates for VLBW infants (< 800 g) have been observed, with survival reaching 49%–70% in recent decades.
Conclusions:
- The increasing survival of infants at the limits of viability necessitates continued medical surveillance.
- Comprehensive strategies are essential to optimize long-term functional, academic, and family outcomes for these vulnerable infants.
- Ongoing research and advocacy are vital to address the evolving needs of ELBW survivors.
Abstract:
Advances in perinatal and neonatal management have resulted in a significant increase in the survival of fragile extremely low birth weight (ELBW) infants > 1,000 g at birth. The evaluation and reporting of the outcome of these infants aids in assessing the efficacy of interventions, provides data to aid in policy decisions, and provides critical information for parents and primary care providers. Comprehensive assessment of multiple domains including neurologic/neurosensory, developmental-cognitive, visual perceptual, speech/language, motor, functional skills for daily living, and Kindergarten readiness permit a total view of the child within the context of the family. Survival of VLBW infants < 800 g has steadily improved from 0% (1943 to 1945) to 49% to 70% (1994 to 1995). Rates of cerebral palsy, mental retardation, blindness, and deafness have remained stable in the 1980s and 1990s. There is evidence, however, that the percent of functional limitations may be increasing. A requirement for Special Education Resources among VLBW infants remains high at 44% to 56%. As increasing numbers of infants at the limits of viability survive, the medical community must remain vigilant in its surveillance and advocate both humanistically and scientifically for comprehensive strategies that optimize long-term functional, academic, and family outcomes.
