Neurological and cognitive outcome of extremely low birth weight (ELBW) and very low birth weight (VLBW) infants and two at four years of age

INTRODUCTION: Follow-up studies on long-term developmental outcomes of children born prematurely with extremely/very low birth weight have steadily increased in number. The present study reports on the developmental status of a sample of ELBW (birth weight <1000g) and VLBW infants (birth weight< 1500g) seen prospectively at two and four years of age, corrected for gestational age prematurity.
OBJECTIVE: The primary objective of the study was to investigate neurological and psychological sequelae in child. The secondary aim was to compare developmental performances at two and four years of age.
EXAMINEES AND METHODS: At the Department for Pediatrics of the Children hospital “Kantrida”, Clinical Hospital Center in Rijeka, in cooperation with the Regional Registry for at risk and impaired children and in the framework of the work of Clinic for children with developmental difficulties, 49 infants of birthrate 1499g (five of birth weight 630-999g and 44 of birth weight 1000-1499g) were monitored.
RESULTS: Major difficulties were diagnosed up to the age of two corrected for the gestational age (21 children had cerebral palsy, vision impairment 19, hearing impairment 1 child). Psychological testing performed at age 4 years detected a significant presence of cognitive disturbances (speech, memory and thought difficulties, attention-deficit, hyperactivity disorder, disturbances in visual perception and perceptual organization, graphomotor function disorder).
CONCLUSION: ELBW/ VLBW infants very often show major development delay with heavy sequelae both in sensorimotor function and mental development.
This at risk population of children needs perspective and targeted organized healthcare with multidisciplinary approach. Furthermore, it is necessary to define the best possible help strategy for specific rehabilitative actions as well as for the organization of education and social care.