Abstract
Aim: To determine neurosensory outcome at 8 years of age of extremely low birthweight (ELBW) children born in the 1990s, how it varies with birth weight, and how it compares with ELBW children born in the 1980s and 1970s.
Methods: Subjects were born in the state of Victoria during 1991–92 and comprised 224 of 241 consecutive survivors with a birth weight of 500–999 g, and 223 of 262 normal birthweight (NBW) controls who had been randomly selected at birth. The comparison cohorts from earlier eras comprised 87 of 89 consecutive ELBW survivors born in 1979–80, 206 of 212 consecutive ELBW survivors born in 1985–87, and 51 of 60 randomly selected NBW survivors born in 1981–82. Survivors were assessed for neurological impairments (cerebral palsy, blindness, deafness, intellectual impairment) and disabilities at 8 years of age by paediatricians and psychologists blinded to perinatal details.
Results: For the 1991–92 cohorts, the rate of neurosensory disability was substantially higher in ELBW children compared with NBW controls (p<0.0001). Within the ELBW group, neurosensory disability was more prevalent in children with a birth weight of <750 g compared with a birth weight of 750–999 g (p = 0.024). Disability rates were lower in the 1991–92 ELBW cohort compared with the ELBW cohort born in 1979–80 (p = 0.046).
Conclusions: Neurosensory disability rates at school age were more common in ELBW children born in the 1990s compared with NBW controls, and were significantly more common in the 500–749 g birthweight subgroup, but have improved compared with ELBW children born in earlier eras.
Full Text
The Full Text of this article is available as a PDF (93.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson Peter, Doyle Lex W., Victorian Infant Collaborative Study Group Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. JAMA. 2003 Jun 25;289(24):3264–3272. doi: 10.1001/jama.289.24.3264. [DOI] [PubMed] [Google Scholar]
- Coskun A., Lequin M., Segal M., Vigneron D. B., Ferriero D. M., Barkovich A. J. Quantitative analysis of MR images in asphyxiated neonates: correlation with neurodevelopmental outcome. AJNR Am J Neuroradiol. 2001 Feb;22(2):400–405. [PMC free article] [PubMed] [Google Scholar]
- D'Angio Carl T., Sinkin Robert A., Stevens Timothy P., Landfish Nancy K., Merzbach Joan L., Ryan Rita M., Phelps Dale L., Palumbo Donna R., Myers Gary J. Longitudinal, 15-year follow-up of children born at less than 29 weeks' gestation after introduction of surfactant therapy into a region: neurologic, cognitive, and educational outcomes. Pediatrics. 2002 Dec;110(6):1094–1102. doi: 10.1542/peds.110.6.1094. [DOI] [PubMed] [Google Scholar]
- Doyle Lex W., Victorian Infant Collaborative Study Group Evaluation of neonatal intensive care for extremely low birth weight infants in Victoria over two decades: I. Effectiveness. Pediatrics. 2004 Mar;113(3 Pt 1):505–509. doi: 10.1542/peds.113.3.505. [DOI] [PubMed] [Google Scholar]
- Flodmark O., Becker L. E., Harwood-Nash D. C., Fitzhardinge P. M., Fitz C. R., Chuang S. H. Correlation between computed tomography and autopsy in premature and full-term neonates that have suffered perinatal asphyxia. Radiology. 1980 Oct;137(1 Pt 1):93–103. doi: 10.1148/radiology.137.1.7422867. [DOI] [PubMed] [Google Scholar]
- Hack M., Taylor H. G., Klein N., Eiben R., Schatschneider C., Mercuri-Minich N. School-age outcomes in children with birth weights under 750 g. N Engl J Med. 1994 Sep 22;331(12):753–759. doi: 10.1056/NEJM199409223311201. [DOI] [PubMed] [Google Scholar]
- Knoches A. M., Doyle L. W. Long-term outcome of infants born preterm. Baillieres Clin Obstet Gynaecol. 1993 Sep;7(3):633–651. doi: 10.1016/s0950-3552(05)80452-3. [DOI] [PubMed] [Google Scholar]
- Ornstein M., Ohlsson A., Edmonds J., Asztalos E. Neonatal follow-up of very low birthweight/extremely low birthweight infants to school age: a critical overview. Acta Paediatr Scand. 1991 Aug-Sep;80(8-9):741–748. doi: 10.1111/j.1651-2227.1991.tb11943.x. [DOI] [PubMed] [Google Scholar]
- Soll R. F. Surfactant treatment of the very preterm infant. Biol Neonate. 1998 Sep;74 (Suppl 1):35–42. doi: 10.1159/000047033. [DOI] [PubMed] [Google Scholar]
- Taylor H. G., Klein N., Minich N. M., Hack M. Middle-school-age outcomes in children with very low birthweight. Child Dev. 2000 Nov-Dec;71(6):1495–1511. doi: 10.1111/1467-8624.00242. [DOI] [PubMed] [Google Scholar]
- Volpe J. J., Herscovitch P., Perlman J. M., Kreusser K. L., Raichle M. E. Positron emission tomography in the asphyxiated term newborn: parasagittal impairment of cerebral blood flow. Ann Neurol. 1985 Mar;17(3):287–296. doi: 10.1002/ana.410170312. [DOI] [PubMed] [Google Scholar]
- Volpe J. J., Pasternak J. F. Parasagittal cerebral injury in neonatal hypoxic-ischemic encephalopathy: clinical and neuroradiologic features. J Pediatr. 1977 Sep;91(3):472–476. doi: 10.1016/s0022-3476(77)81328-0. [DOI] [PubMed] [Google Scholar]
- Whitfield M. F., Grunau R. V., Holsti L. Extremely premature (< or = 800 g) schoolchildren: multiple areas of hidden disability. Arch Dis Child Fetal Neonatal Ed. 1997 Sep;77(2):F85–F90. doi: 10.1136/fn.77.2.f85. [DOI] [PMC free article] [PubMed] [Google Scholar]