Risk factors for adverse neurodevelopment in extremely low birth weight infants with normal neonatal cranial ultrasound.
OBJECTIVE
To determine risk factors associated with adverse developmental outcome at 5 years in extremely low birth weight infants or extremely premature infants (<28 weeks) with normal neonatal cranial ultrasounds.


METHODS
Data were collected prospectively on 152 infants with gestation <28 weeks or birth-weight <1000 g. Infants were grouped into those with normal development, mild-to-moderate impairment (IQ 70 to 84, or hearing loss 30 to 89 dB, visual acuity 6/18 to 6/60, or mild/moderate cerebral palsy (CP)) and severe impairment (IQ <70, hearing loss > or =90 dB, visual acuity <6/60, or severe CP).


RESULTS
Five-year outcomes were available for 144/152 children (95%). In all, 89 (62%) infants had normal development, 39 (27%) had mild-moderate impairment and 16 (11%) had severe impairment. On multivariate logistic regression analysis, factors associated with developmental impairment were serum bilirubin > or =200 micromol/l (odds ratio (OR) - 4.06, p=0.003) and retinopathy of prematurity (ROP) (OR - 1.6, p=0.03).


CONCLUSIONS
A serum bilirubin > or =200 micromol/l and presence of ROP are postnatal risk factors associated with an adverse developmental outcome in infants with normal cranial ultrasounds.
Sampath
Venkatesh
V
Department of Neonatal Medicine, Royal North Shore Hospital, Sydney.
Bowen
Jennifer
J
Gibson
Frances
F
D001663:Bilirubin / Q000097:blood; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007360:Intelligence; D011446:Prospective Studies; D012178:Retinopathy of Prematurity / Q000209:etiology; D012307:Risk Factors; D012886:Skull / Q000000981:diagnostic imaging*; D014463:Ultrasonography
D001663:Bilirubin