360 9 Years Follow up of Preterm Infants < or = 28 Weeks at Birth

Abstract

Background: School performances are a concern in very small infants as they are at excess risk for mental retardation and borderline intelligence.Objective: Social and academic assessment at 9 years of age of preterm infants < or = 28 weeks gestation.Methods: All the 96 infants < or = 28 weeks gestation admitted in the NICU between January 1, 1992 and December 31, 1994 were included at birth in a prospective follow up. At 9 years of age 80 (83.3%) are alive. One with a cerebral tumor was excluded from the study. 3 could not be located from the age of 4. We sent the 76 families a questionnaire concerning academic results, school and extra-school supports.Results: 59/76 families answered (77,6%). 14/17 families who did not answer the questionnaire had a child considered as normal at the age of 4. 40/59 (67,8%) are attending school at an age appropriate level. 25/59 (42,4%) follow speech therapy ; 24/59 (40,7%) have a psychological or psychiatric support ; 14/59 (23,7%) have psychomotricity ; 10/59 (16,9%) follow a school support ; 5/59 (8,5%) have a physical therapy ; 9/57 (15,7%) are in special schools. For nearly half of the children (27/59) shyness or lower self-confidence is mentioned. Only 3/11 (27,3%) children who repeat a school year, follow easily the school curriculum afterwards.Conclusions: Only 33,9% (20/59) have no school or extra-school support. The rate of children attending school at an age-appropriate level is less important for the children who had a neurodevelopmental delay at 4 ( 14,3%) in comparison with those who were considered as normal at 4 (88,9%) or with those who had behavioural disturbance at 4 (90,9%). The data confirm that we must have a long term follow up for the very preterm infants and that the capacities of our support have to be improved.