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.
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.
Shankaran
Seetha
S
Wayne State University, Detroit, MI, USA. sshankar@med.wayne.edu
Johnson
Yvette
Y
Langer
John C
JC
Vohr
Betty R
BR
Fanaroff
Avroy A
AA
Wright
Linda L
LL
Poole
W Kenneth
WK
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