PEDIATRICS Vol. 54 No. 6 December 1974, pp. 724-735
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Improved Prognosis for Infants of Very Low Birthweight

Ann L. Stewart M.B., Ch.B.1 and E. O. R. Reynolds M.D., M.R.C.P.1

1 Medical Research Council, Human Biochemical Genetics Unit, University College, and the Department of Paediatrics, University College Hospital and Medical School, London

Following the introduction of a program of intensive care for infants of very low birthweight, 197 infants who weighed 1,500 gm or less at birth were cared for in the Neonatal Unit of University College Hospital, London, in the five years from 1966 to 1970. During this period, the neonatal survival rate for infants weighing 501 to 1,000 gm was 23% and for those weighing 1,001 to 1,500 gm was 69%. The principal immediate cause of death was hypoxia around the time of birth or hyaline membrane disease. Ninety-five of the 98 surviving children, aged 2 years 10 months to 7 years 10 months (mean, 5 years 2 months) were followed up. They all had repeated physical examinations and developmental assessments. Sixty-five of the older children also had IQ tests. The results showed that 86 (90.5%) of the children had no detectable handicap, 4 (4.2%) had physical handicaps only, and S (5.3%) had mental handicaps, including two children with physical handicaps. The incidence of handicap was very much greater among infants presumed to have been severely hypoxic than among the remaining infants.

We conclude that intensive care can both increase the chance of survival for infants of very low birthweight amid reduce the incidence of serious handicap in survivors.

Submitted on February 19, 1974
Accepted on March 15, 1974




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