Regional differences in outcome for very low-birthweight infants: do they persist at 7-8 years of age?
OBJECTIVE
To determine whether regional differences in early neonatal morbidity in a national cohort of very low-birthweight (VLBW) infants persisted at 7-8 years of age.


METHODS
Perinatal data collected prospectively from birth on all VLBW infants born in New Zealand in 1986 and admitted to a neonatal unit included the hospital principally caring for the infant: hospitals A-D being level III hospitals and 'Other' including the smallest level III and all level II hospitals. At 7-8 years of age, 298 surviving children (96% survivors living in New Zealand) were assessed at a home visit. Parents were given a comprehensive questionnaire to complete, the children underwent a visual examination and were tested with the Revised Wechsler Intelligence Scale for Children and the child's teacher was sent a questionnaire to complete.


RESULTS
Neonatal survival was significantly greater in the two largest hospitals (A and B) and this difference in survival remained at 7-8 years of age after adjustment for perinatal factors (P < 0.05). There were no differences between hospitals in risks of long-term sensorineural disability and behavioural or educational outcomes. There were interhospital differences in rates of visual problems and, after adjustment for confounding factors, there remained a marginally significant (P = 0.06) increased risk of myopia in hospital D.


CONCLUSIONS
Despite differences in early morbidity favouring larger hospitals, there were no substantive differences in long-term (7-8 years) outcomes across a range of measures in this national cohort of VLBW infants.
Darlow
B A
BA
Department of Paediatrics, Christchurch School of Medicine, New Zealand. brian.darlow@chmeds.ac.nz
Horwood
L J
LJ
Mogridge
N
N
D000124:Achievement; D000367:Age Factors; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate