Physical growth and neurodevelopmental outcome of nonhandicapped low-risk children born preterm.
BACKGROUND
Outcome studies on the effects of prematurity are increasingly restricted to extremely immature infants with birth weight below 1000 g or gestational age below 26 weeks. In contrast, studies comprising low-risk preterm infants are rare.


OBJECTIVE
To examine growth and neurodevelopmental outcome, 70 low-risk low birth weight (LBW) children without neurological impairment were followed from birth to 7 years of age. At 7 years of age, LBW children were compared to a matched control group born at term.


METHODS
Postnatal growth was measured at 20 months in the LBW group and at 7 years in LBW and control children. At 20 months, the LBW group was assessed with the Griffiths Scales. At 7 years, LBW and control children were assessed with a neuropsychological test battery comprising tests for language, visual-perceptual, visual-motor, fine and gross motor abilities.


RESULTS
At 7 years of age, the frequency of children with low (3rd-9th percentile) or subnormal (<3rd percentile) growth parameters was increased in the LBW group. The Mean Griffiths Developmental Quotient (DQ) of the preterm group was normal (102.3+/-8.4), and there were only two results below DQ 85. There was no difference between 49 children appropriate for gestational age and 21 small for gestational age (SGA) children. At 7 years of age, reduced mean test results in the range of -0.5 SDS were observed for language and visual-motor abilities in the preterm group. This was due to an increased frequency of LBW children with moderately (SDS -1.0 to -2.0 SDS) subnormal test results. Even for the slightly LBW group (2000 to 2499 g), poorer language abilities were confirmed.


CONCLUSIONS
All LBW infants, including low-risk populations, should be included in a follow-up program in order to detect deficits early in life and begin treatment before school entry.
Department of Pediatric Neurology, University of Heidelberg, Im Neuenheimer Feld 150, D-69120 Heidelberg, Germany. Joachim_Pietz@med.uni-heidelberg.de
Joachim
J
Pietz
Johannes
J
Peter
Rainer
R
Graf
Inge
I
Rauterberg-Ruland
André
A
Rupp
Dieter
D
Sontheimer
Otwin
O
Linderkamp
D000328:Adult; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development* / Q000523:psychology; D007805:Language Development Disorders / Q000209:etiology*; D008297:Male; D009420:Nervous System / Q000254:growth & development*; D009483:Neuropsychological Tests; D011247:Pregnancy; D047928:Premature Birth / Q000150:complications*