[Long-term prognosis for premature infants].
Recent advances in perinatology have been associated with a decrease in perinatal mortality among very low birth weight (VLBW) infants. However, only comprehensive follow-up programmes allow obstetricians and neonatologists to measure short-term and long-term effects of neonatal intensive care. In our experience, sequential brain ultrasonography together with serial neurological assessments during the neonatal period play an important role in the prediction of later neurodevelopmental outcome. Major sequelae are closely related to periventricular leukomalacia and extensive parenchymal haemorrhage. With improving knowledge of the physiopathology of cerebral damage, more effective preventive measures are now being taken. Nowadays, the incidence of major handicaps (5%) is steadily decreasing among VLBW survivors. Only a few comprehensive studies have regularly followed up preterm infants until school age. Our results showed that 17% of VLBW infants had minor neurodevelopmental abnormalities (visuomotor or motor disorders and language disorders) at 8 years of age. School failure was frequently found among children who presented the association of several neurodevelopmental abnormalities. Most of these developmental problems can be detected in preschool age, and early recognition may allow better counselling of parents and appropriate intervention. An optimistic attitude regarding the outcome in VLBW infants without cerebral lesions or associated neurodevelopmental abnormalities is certainly justified at the present time. These results emphasize the importance of optimal perinatal intensive care for VLBW infants.
Calame
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Service de pédiatrie, Centre hospitalier universitaire vaudois, Lausanne.
D001925:Brain Damage, Chronic / Q000517:prevention & control; D002657:Child Development; D002658:Developmental Disabilities / Q000517:prevention & control; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D011597:Psychomotor Performance
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