The long-term neurodevelopmental outcome for very low birthweight (VLBW) infants with 'dystonic' signs at 4 months of age.
As very low birthweight (VLBW) infants are at a high risk of developmental handicap, it is important to establish predictors of long-term adverse outcome at an early age so that early intervention can be instituted. Longitudinal neurodevelopmental assessments were performed in 107 VLBW infants at 1, 4, 8 and 12 months corrected age. Eighteen were diagnosed as 'dystonic' at 4 months of age. This study compared the outcomes at 4 and 6 years for 15 of the 18 dystonic with 75 of the 89 non-dystonic VLBW infants, respectively. At 9 years of age, nine dystonic and 54 non-dystonic infants were assessed on the Rutter Behaviour Questionnaire. Dystonic children had a lower mean General Cognitive Index (GCI; P = 0.001) and a higher incidence of disability as measured by the Burns Neuro-Sensori-Motor Developmental Assessment Scale (P = 0.0005) and Kitchen disability grading (P = 0.001). Even if the minor neurological aberrations of the premature dystonia syndrome in VLBW infants abate by one year of life, these infants still constitute a high-risk group for subsequent neurodevelopmental disability and therefore require close observation and probably early intervention.
Khadilkar
V
V
Growth and Development Clinic, Mater Misericordiae Public Hospital, South Brisbane, Queensland, Australia.
Tudehope
D
D
Burns
Y
Y
O'Callaghan
M
M
Mohay
H
H
D016022:Case-Control Studies; D002658:Developmental Disabilities / Q000209:etiology*; D004421:Dystonia / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D009422:Nervous System Diseases / Q000209:etiology*