The survival and developmental outcome of extremely low birthweight infants

Author(s): Dolcourt, J., King, J., Bodnar, A., Beck, D.

Journal/Book: Infant Mental Hlth J. 1996; 17: Michigan State Univ, Dept Psychology, E Lansing, MI 48824-1117. Michigan Assn Infant Mental Health. 375-385.

Abstract: The purpose of this retrospective study is to compare the factors affecting the survival and developmental outcome of extremely low birthweight infants (ELBW; < 1,001 gms.). One hundred and forty of two hundred and twenty-three ELBW neonates (63%) from two Level III NICUs born between 1986 and 1988 survived until discharge. Lower birthweight, 5-minute Apgar less than or equal to 3, and no administration of surfactant were the best predictors of infant mortality as assessed via logistic regression (correct classification = 78%). The functioning of 34 of these infants was assessed at approximately 18 months of age with the Bayley Scales of Infant Development. Mean performance on the Mental Development Index (MDI) was 88.65 +/- 21.75, with 35.3% and 20.6% of infants scoring, respectively, 1 (< 85) and 2 (< 70) standard deviations below the mean. Given survival, intraventricular hemorrhage (IVH, Grade III or IV) was the best predictor of MDI performance as assessed via stepwise multiple regression (adjusted R(2) = .23). Cerebral palsy affected one fifth of the sample and was also best predicted by IVH. Discussion focuses on the conceptual and practical implications of the finding that infant survival and infant developmental status were associated with different factors.

Note: Article Messinger D, Univ Miami, Dept Pediat, Miami,FL 33101 USA

Keyword(s): LOW-BIRTH-WEIGHT; SCHOOL-AGE; 1250 GRAMS; 1ST YEAR; PREMATURITY; SEQUELAE; CHILDREN; PRETERM; TRENDS; HEALTH

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