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PEDIATRICS Vol. 100 No. 4 October 1997, pp. 633-639

Outcome of Extremely Low Birth Weight Infants (500 to 999 Grams) Over a 12-Year Period

Received Nov 18, 1996; accepted Mar 6, 1997.

Robert E. Piecuch*, Carol H. Leonard*, Bruce A. CooperDagger , and Sally A. Sehring*

From the * Department of Pediatrics, University of California, San Francisco, San Francisco, California, and the Dagger  California School of Professional Psychology, Alameda, California.

Objective.  Advances in neonatology have contributed to improved survival for extremely low birth weight (ELBW) infants. Neurodevelopmental outcome is usually reported for a single large group of infants rather than according to smaller birth weight groups because of small numbers. Our purpose was to review the neurodevelopmental outcome of a large group of ELBW infants and examine differential outcome according to birth weight.

Study Design.  A total of 446 infants born between 1979 and 1991, with a birth weight of 500 to 999 g, were followed to mean age 55 months ± 33 standard deviation. Univariate analyses of medical risk factors of birth weight, gestational age, year of birth, growth retardation, gender, inborn/outborn status, days on oxygen, intracranial hemorrhage, and social risk in relation to outcome were conducted on the group as a whole. Neurologic/developmental outcome was also analyzed by 100-g weight groups.

Results.  A total of 61% of all infants were completely normal, with no neurologic, neurosensory, or cognitive deficits. There was no association between outcome and birth weight. There was a strong association between intracranial hemorrhage (ICH) grade III or IV and/or cystic periventricular leukomalacia (PVL) and abnormal outcome (Somers' D = .17) and ICH III/IV and/or cystic PVL and cognitive outcome (Kendall's tau = .15). Mild to moderate cognitive delays were associated with chronic lung disease (oxygen >60 days) (Kruskal-Wallis chi 2 = 17.53) or high social risk (Kruskal-Wallis chi 2 = 22.17).

Conclusion.  In this study of ELBW infants, low birth weight was not associated with abnormal outcome. The risk factors of ICH III-IV/cystic PVL, chronic lung disease, and high social risk were associated with abnormal outcome.

Key words: ELBW, neurodevelopment, outcome, premature, risk.




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