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[Outcome at 3 years of age in a low birth weight cohort]
C R Pallás Alonso1, J de la Cruz Bertolo, M C Medina López
1Servicio de Neonatología del Hospital 12 de Octubre, Madrid.
Insights
Very low birth weight (VLBW) survivors had high rates of neurosensory disability (28.5%) and cerebral palsy (13%) by age 3. Disadvantaged families were less likely to complete follow-up, potentially biasing results.
Area of Science:
- Neonatal care and developmental pediatrics.
- Longitudinal studies on infant outcomes.
Context:
- Assessing long-term neurodevelopmental outcomes in preterm infants is crucial.
- Very low birth weight (VLBW) infants face increased risks for developmental challenges.
Purpose:
- To determine the 3-year neurodevelopmental outcomes for VLBW infants.
- To identify rates of neurosensory disability and cerebral palsy in this cohort.
Summary:
- A follow-up study assessed 137 VLBW survivors (500-1,499g) at 3 years.
- Neurosensory disability affected 28.5% (mild 16%, moderate 5%, severe 7%).
- Cerebral palsy, blindness, and deafness rates were 13%, 1.4%, and 0.7%, respectively.
Impact:
- Findings highlight significant neurodevelopmental challenges in VLBW survivors.
- Disadvantaged socioeconomic background is associated with higher dropout rates, indicating potential follow-up bias.
- Early identification and intervention are critical for improving outcomes in VLBW infants.
Objective:
The objective of this study was to establish the outcome at 3 years of age for very low birth weight newborns admitted to the Hospital 12 de Octubre from January 1991 to December 1993.
Patients And Methods:
A follow-up study was performed. The pediatric assessment included a neurological, psychological, visual and audiological evaluation. At the end of the follow-up, children were blindly assessed to determine the rate of neurosensory disability. The severity of the neurosensory disability was graded as severe, moderate or mild by a functional classification. The rates of cerebral palsy, blindness and deafness were reported.
Results:
Two hundred fifty-three infants between 500 and 1,499 g were admitted to the Hospital 12 de Octubre of which 182 survived. Of these, 137 (75% of the survivors) were assessed at 3 years of age. The children who dropped out during the follow-up period had similar characteristics to those with a complete follow-up program except that the drop-out child was more likely to belong to a disadvantaged family. The rate of neurosensory disability was 28.5% (39/137), 16% were mild, 5% moderate and 7% severe. The rate of cerebral palsy was 13% (18/137), blindness 1.4% and deafness 0.7%.
Conclusions:
Children from more disadvantaged families are less likely to continue in follow-up programs and this supposes a bias in the follow-up program. At 3 years, neurosensory disability was diagnosed in 1 out of every 4 children and cerebral palsy in 1 out of 8 children.