Two-year neurodevelopmental outcome of preterm born children ≤ 750 g at birth.
OBJECTIVE
To describe 2-year neurodevelopmental outcome (NDO) in a cohort of extremely low birthweight infants, and compare NDO between two consecutive 5-year periods and between appropriate (AGA, ≥p10) and small for gestational age (SGA, <p10) infants.


METHODS
Retrospective cohort study.


METHODS
Wilhelmina Children's Hospital, Utrecht, the Netherlands.


METHODS
146 children, born between 1996 and 2005, with a birth weight ≤750 g and a gestational age ≥24 weeks, admitted to the neonatal intensive care unit. 111 children (76%) survived the neonatal period.


METHODS
At 2 years corrected age, 101 children (cohort I: born in 1996-2000, n=45 and cohort II: born in 2001-2005, n=56) were assessed with either the Griffiths Mental Developmental Scales or the Mental Scale of the Bayley Scales of Infant Development, second edition.


METHODS
NDO, classified as normal (≤-1 Z score ≥0), mildly delayed (>-1 Z score ≤-2) or severely delayed (Z score >-2).


RESULTS
74.3% of the children had a normal NDO at 2 years corrected age, 20.8% a mildly and 5% a severely delayed outcome. Although survival significantly increased with time (65.8% to 88.1%, p=0.002), significantly fewer children in cohort II (66.1% vs 84.4% in cohort I, p=0.042) as well as fewer SGA children (64.3% vs 86.7% of AGA children, p=0.012) had a normal NDO.


CONCLUSIONS
Increased survival of infants with a birth weight ≤750 g coincided with more children with an impaired NDO at 2 years corrected age. SGA infants are especially at risk of impaired NDO.
Department of Obstetrics and Gynaecology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, the Netherlands. m.j.claas@umcutrecht.nl
M J
MJ
Claas
H W
HW
Bruinse
C
C
Koopman
I C
IC
van Haastert
L M
LM
Peelen
L S
LS
de Vries
D001724:Birth Weight; D002658:Developmental Disabilities / Q000209:etiology*; D004812:Epidemiologic Methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D007236:Infant, Small for Gestational Age / Q000523:psychology; D019102:Infant, Very Low Birth Weight / Q000523:psychology; D007363:Intensive Care Units, Neonatal; D008297:Male; D011379:Prognosis; D011594:Psychometrics