[Prognostic factors for cognitive development of very low birth weight premature children].
OBJECTIVE
Very low birth weight premature children often show cognitive development abnormalities. There is scarce information about the outcome of these children at preschool age in Brazil. The objective of the study is to describe the cognitive development of a population of premature newborns and to assess possible prognostic factors for abnormalities.


METHODS
A cohort study was conducted in a preschool children population whose subjects were very low birth weight premature babies born between January 1991 and September 1993. WPPSI-R Test was used for cognitive evaluation and it was applied by psychologists. Two cut-offs were set to describe abnormality: scores below 1 and 2 standard deviations (SD).


RESULTS
Seventy-nine children aged 4 and 5 years were studied. The mean full WIPPSI-R score was 75.6 (+/-11.9). The incidence of abnormal 1 and 2 SD full score was 77.2% and 32.9%, respectively. After adjusting for the method of delivery, small for gestational age (OR=6.19, 95% CI 1.60-23.86), abnormal cerebral ultrasound exam (OR=5.90, 95% CI 1.04-9.83) and male sex (OR=3.20, 95% CI 1.32-26.35) were predictors of full score <70.


CONCLUSIONS
Compared to the literature, these children showed a more severe cognitive development impairment. Small for gestational age, abnormal cerebral ultrasound exam and male sex were prognostic factors for worse outcome.
Méio
Maria Dalva Barbosa Baker
MD
Departamento de Neonatologia, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. mdmeio@centroin.com.br
Lopes
Claudia S
CS
Morsch
Denise Streit
DS
D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D008297:Male; D011379:Prognosis; D011581:Psychological Tests; D012737:Sex Factors