[Development of formerly preterm infants with a birth weight of below 1500 grams: concept and results of a follow-up program in up to school-aged children in central Switzerland].
OBJECTIVE
To document the psychomotor development and general health of former very low birthweight infants born between 1980 and 1986 from birth up to school age. We wished to evaluate the quality of neonatal intensive care in Central Switzerland over this time period and test the reliability of a patient-oriented follow-up programme. If successful, the latter could perhaps serve as a model for a national follow-up programme in Switzerland.


METHODS
Information regarding three different developmental periods was collected. The medical records of the perinatal period were used to abstract details of labour and delivery and the neonatal period. The records of the infant follow-up programme were used to describe psychomotor development between 0 and 24 months of age. The current health status and school performance were evaluated using a questionnaire sent to parents and teachers.


RESULTS
Of 139 infants born with a birthweight of < or = 1500 g, 102 were discharged home (mortality rate 26.6%). One third was not screened for hearing deficits or retinopathy of prematurity. Eighty-two were seen in the infant follow-up programme between 0 and 24 months of age. Seventy-seven percent of these infants were judged to be normal and discharged from the infant follow-up programme; 1/5 of these infants had had transient motor problems treated by physical therapy. Twenty-three percent of the infants seen in infant follow-up had persistent but mainly minor motor handicaps, and only two infants (2%) had multiple handicaps. At school age, data from 99 of the 102 surviving infants was collected. Ninety-six percent attended regular school, but almost half of them had significant school problems and required professional help. These problems correlated poorly with the results of examinations during early childhood (positive predictive value 67%).


CONCLUSIONS
These long-term results of a population of preterm infants born in Central Switzerland in the 1980s are encouraging. To ensure completeness of early ophthalmological and audiological examinations of all former small preterm infants, neonatal follow-up programmes should adhere to uniform guidelines.
Schubiger
G
G
Pädiatrische Klinik, Kinderspital Luzern. Kispiluzern@bluewin.ch
Lanz
F Z
FZ
Caflisch
U
U
Lanz
C
C
D000293:Adolescent; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D008499:Medical Records; D011597:Psychomotor Performance; D011785:Quality Assurance, Health Care; D013557:Switzerland
Entwicklung ehemaliger Frühgeborener mit einem Geburtsgewicht unter 1500 Gramm: Konzept und Resultate von Nachkontrollen bis zum Schulalter in der Zentralschweiz.