Surfactant era (1990–2002) 2-year outcomes of infants less than 1500 g from a Community Level 3 Neonatal Intensive Care Unit

Abstract

To report Bayley scores of 572 twenty-four-month corrected age infants whose birth weights (BWs) were less than 1500 g cared for in a Community Level 3 Neonatal Intensive Care Unit (NICU) between 1990 and 2002 when surfactant was routinely used. Survival, "normal" defined as both Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI)>84, MDI>69 and MDI>84 were analyzed by gestational age (GA) and BW. Comparisons were made between infants born pre- and post-1996 when high-frequency oscillatory ventilation came into frequent use, Medicaid and non-Medicaid infants, multiples and singletons, outborn and inborn infants, boys and girls and infants with intrauterine growth retardation (IUGR) and those appropriate for gestational age (AGA). There was a correlation between GA and BW and improving outcomes. Scores do not approach those of normal standardization sample populations (60% for "normal", 68% for MDI>84 and 95% for MDI>69) until 1400 g and 30 weeks. Medicaid, outborn and IUGR infants, and boys did worse in some aspects. There was a correlation between both GA and BW and improving outcomes. Availability of these developmental data on a laminated pocket card can facilitate presentation of outcome experience to families by pediatric and obstetric caregivers.