title: Outcome of extremely-low-birth-weight infants at highest risk: gestational age < or =24 weeks, birth weight < or =750 g, and 1-minute Apgar < or =3.
abstract: OBJECTIVE
  The purpose of this study was to evaluate neurodevelopmental outcome in extremely-low-birth-weight (ELBW) infants, all of whom had 3 characteristics: gestational age (GA) < or =24 weeks, birth weight < or =750 g, and 1-minute Apgar score < or =3.
  
  
  METHODS
  Surviving infants were evaluated at 18 to 22 months' corrected age with a neurologic examination and the Bayley II Mental and Psychomotor Developmental Index (MDI and PDI).
  
  
  RESULTS
  Between 1993 and 1999, 1016 infants had GA < or =24 weeks, birth weight < or =750 g, and 1-minute Apgar score < or =3. Of 246 survivors, 30% had cerebral palsy (CP), 5% had hearing impairment, and 2% were blind. MDI was > or =85 in 33% and < 70 in 46% of infants, while PDI was > or =85 in 41% and < 70 in 36% infants. Predictors of MDI < 70 were grade III-IV ICH, cystic periventricular leukomalacia (PVL), male gender, black race, and Medicaid insurance. Two-parent household was associated with an MDI >70. Predictors of PDI < 70 were grade III-IV ICH, PVL, steroids for bronchopulmonary dysplasia (BPD), and Medicaid insurance. CP was associated with grade III-IV ICH and PVL.
  
  
  CONCLUSIONS
  Perinatologists and neonatologists should be aware of the risk of morbidity and mortality in this high-risk ELBW group.
authors.affiliation: Wayne State University, Detroit, MI, USA. sshankar@med.wayne.edu
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
authors.forename: Yvette
authors.initials: Y
authors.lastname: Johnson
authors.forename: John C
authors.initials: JC
authors.lastname: Langer
authors.forename: Betty R
authors.initials: BR
authors.lastname: Vohr
authors.forename: Avroy A
authors.initials: AA
authors.lastname: Fanaroff
authors.forename: Linda L
authors.initials: LL
authors.lastname: Wright
authors.forename: W Kenneth
authors.initials: WK
authors.lastname: Poole
mesh_terms: D001034:Apgar Score; D002657:Child Development; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D009017:Morbidity; D009460:Neurologic Examination