[Psychomotor development at the age of 5-7 years of very low birth weight infants].
BACKGROUND
Very low birth weight (VLBW) infants are at greater risk for neurodevelopmental delay, cerebral palsy (CP), vision and hearing impairment, and cognitive and emotional problems. The aim of the study was assessment of neurodevelopmental outcomes at the age of 5-7 years among VLBW infants and evaluation of prognostic value of selected perinatal risk factors.


METHODS
A sample of 73 VLBW infants with mean birtweight 1075g and mean gestational age 28.9 weeks were evaluated. Infants were divided into 3 groups: (A) normal development (n = 35; 48%), (B) mild-to-moderate impairment (IQ 68-83, or mild to moderate hearing loss or visual problems, or mild/moderate CP or ADHD) (n = 25; 36%) and (C) severe impairment (IQ < 68, deafness, blindness or severe CP) (n = 13; 18%)


RESULTS
The studied groups differ in respect to: gestational age (mean +/- SEM: 29.7 +/- 2.3 vs 28.1 +/- 2.5 vs 28.5 +/- 2.3 wks; p = 0.03), prevalence of retinopathy (ROP) (17 vs 28 vs 69%; p < 0.01), bronchopulmonary dysplasia (BPD) (31 vs 17 vs 62%; p = 0.03) and periventricular leukomalacia (PVL) (3 vs 0 vs 23%; p < 0.02). Maximum bilirubin concentration was higher in children with severe impairment (mean +/- SEM: 177 +/- 60 vs 193 +/- 45 vs 229 +/- 48 micromol/l; p < 0.05). On multivariate logistic regression analysis, factors associated with developmental impairment were serum bilirubin > or = 200 micromol/ I and ROP.


CONCLUSIONS
The significant risk factors of poor neuro-developmental outcomes at the age of 5-7 years among VLBW infants are: gestational age, PVL, ROP, BPD and serum bilirubin concentration > 200 micromol/I.
Kwinta
Przemko
P
Klinika Chorób Dzieci Katedry Pediatrii, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie. kwintap@mp.pl
Klimek
Małgorzata
M
Nitecka
Magdalena
M
Pietrzyk
Jacek J
JJ
D002648:Child; D002675:Child, Preschool; 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; D015995:Prevalence; D011596:Psychomotor Disorders / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index