Neurodevelopmental outcome of very low birth weight babies admitted to a Malaysian nursery.
OBJECTIVE
To examine the prevalence and pattern of neurodevelopmental handicap at 2 years of age in very low birth weight infants (VLBW) admitted in 1993 to a level 3 Malaysian nursery.


METHODS
All VLBW babies born in the hospital or referred for neonatal care during 1993 were enrolled prospectively in the study. At 2 years of age development was assessed using the Griffiths mental scales. Neurological, hearing and visual assessments were graded into five groups according to functional handicap. Control infants were randomly selected during attendance at a primary health care clinic.


RESULTS
One hundred and fifty VLBW infants were admitted and 82 (54.6%) survived to 2 years, of whom 77 (93.9%) were assessed. The mean General Quotient (GQ) on the Griffiths Scales was 94 (15.7) for the study group and 104 (8.3) for the 60 controls. For GQ, 21 (27.3%) of the study population were 1 or more SD below the mean (18 between 1 and 2 SD and 3 > 2 SD) compared with 1 (1.6%) of the controls who was 1-2 SD below the mean. Visual impairment occurred in 2 study infants and none of the controls. There was no hearing impairment in either group. Cerebral palsy occurred in 3 (1 mild and 2 moderate-severe) of the study group and none of the controls. Functionally 18 (23.3%) of the study group had mild handicap, 1 (1.3%) moderate, 2 (2.5%) severe, 2 (2.5%) multiply severe and 54 (70.2%) were normal.


CONCLUSIONS
Although survival was low, overall rates of functional handicap were similar to those reported in developed countries but the proportion with moderate or severe handicap was low.
Ho
J J
JJ
Asean Sheffield Medical College, Ipoh, Malaysia.
Amar
H S
HS
Mohan
A J
AJ
Hon
T H
TH
D000704:Analysis of Variance; D016022:Case-Control Studies; D002490:Central Nervous System / Q000254:growth & development*; D016009:Chi-Square Distribution; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D016001:Confidence Intervals; D003906:Developing Countries; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology; D009725:Nurseries, Hospital / Q000706:statistics & numerical data; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012923:Social Class