Extremely Low Birthweight (ELBW) Infants: Follow-Up To 12.5 Years 1356

Abstract

Continuing concerns have arisen regarding the quality of life for the progressively smaller and less mature survivors of neonatal intensive care, yet relatively few studies have reported outcome beyond age five. This study followed a cohort of ELBW (≤1000g) survivors from our tertiary care NICU into their intermediate school years. Of 129 ELBW admissions 1983-1985 (76% inborn), 69 (53%) survived to discharge (27%≤750g vs 70%>750g BW; p 85, without neuromotor/sensory dysfunction), 25(50%) were mildly impaired (MI) and 11 (22%) were moderately to severely impaired (MSI). The MI group included 22 with fine and/or gross motor incoordination, 11 with borderline IQ (71-85), 11 with learning problems and 4 with ADHD. Eight of the 11 MSI children (8M, 3F) had multiple disabilities including 3 with severe visual impairment, 5 with shunted hydrocephalus, 5 with CP and 9 with MR. Poorer neurodevelopmental outcomes were associated with prolonged mechanical ventilation, P-IVH, or non-Caucasian race (p<0.05). Educational status was tracked to a mean age of 12.5±1.1 yrs for 50 of the 51 children (1 MSI child lost to follow-up). Thirty-one (62%) children including the remaining 10 in the MSI group, 20 of 25 in the MI group, and 1 in the NL group were receiving special services. Fourteen children were in special self-contained class settings, and 17 were in regular classrooms with additional remedial/tutorial help and/or rehabilitation therapies. One child with learning disabilities was home schooled. While this study supports the literature showing that the majority of ELBW survivors are free of major neurodevelopmental impairments, it underscores the importance of monitoring these children well into their school years, as a large proportion have milder deficits requiring special educational assistance.