Structure Versus Function: Time Will Always Tell

Abstract

The article by Laptook et al1 in the March issue of Pediatrics examined clinical follow-up assessments at 18 to 22 months’ corrected age of an extremely low birth weight (ELBW) infant cohort cared for in the Neonatal Research Network Centers within the years 1995–1999. From the study cohort of 1749 infants, 84% (1473 infants) returned for follow-up assessments. The authors found that nearly 30% of those infants with a normal, early, and late head ultrasound (HUS) (performed at a mean age of 6 and 47 days, respectively) were found later to have either cerebral palsy (CP) (9.4%) and/or a low (<70) Mental Developmental Index (25.3%) on Bailey Scales of Infant Development II. All infants included in the study had a birth weight of 729 ± 134 g and a gestational age of 26 ± 2 weeks. Multivariate analyses revealed that factors associated with subsequent CP were male gender, multiple birth, decreasing birth weight, pneumothorax, and days of mechanical ventilation.1 The same factors, with the exception of pneumothorax, were associated with a Mental Developmental Index of <70 in addition to less maternal education and having Medicaid or lack of coverage for maternal insurance. Equally important, however, is the … Reprint requests to (F.J.D.) Department of Pediatrics, Connecticut Children’s Medical Center, 282 Washington St, Suite 2A, Hartford, CT 06106. E-mail: fdimari{at}ccmckids.org