Functional assessment of a multicenter very low-birth-weight cohort at age 5 years. Newborn Lung Project.

Published

Journal Article

BACKGROUND: Very low-birth-weight newborns (birth weight < or = 1500 g) experience serious neonatal complications, but long-term outcomes are not completely known. Most studies reflect an era of neonatal care that was fundamentally different from the present. OBJECTIVES: To compare the functional level of very low-birth-weight children before and after surfactant introduction and to relate functional level to clinical and socioeconomic factors. DESIGN: Inception cohort followed up from birth to an average age of 5 years. SETTING: Six regional neonatal intensive care units in a contiguous geographic area. PARTICIPANTS: Four hundred twenty-five very low-birth-weight children, born between August 1, 1988, and June 30, 1991, of 438 located among 626 whose parents provided follow-up information before neonatal intensive care unit discharge. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Diagnosis of cerebral palsy and standardized scores for self-care, mobility, and social function from the Pediatric Evaluation of Disability Inventory. RESULTS: Cerebral palsy was present in 12.6% of the children, with no change after surfactant introduction. Intraventricular hemorrhage (odds ratio, 2.3 per grade; 95% confidence interval, 1.8-2.8) and bronchopulmonary dysplasia (odds ratio, 2.3; 95% confidence interval, 1.2-4.6) were independently predictive of cerebral palsy and of functional outcome. For self-care, mobility, and social function, 11.7%, 29.5%, and 10.7% of the children, respectively, scored at least 2 SDs below the normative means. Social function was 0.25 to 0.50 normative SDs lower after general surfactant availability than before general surfactant availability. CONCLUSIONS: While there was no increase in major disability after surfactant introduction, there may have been a decrease in social function associated with the lower neonatal mortality. Most very low-birth-weight children functioned within the normal range in everyday tasks. Several predictors of outcome were identified.

Full Text

Duke Authors

Cited Authors

  • Palta, M; Sadek-Badawi, M; Evans, M; Weinstein, MR; McGuinnes, G

Published Date

  • January 2000

Published In

Volume / Issue

  • 154 / 1

Start / End Page

  • 23 - 30

PubMed ID

  • 10632246

Pubmed Central ID

  • 10632246

International Standard Serial Number (ISSN)

  • 1072-4710

Language

  • eng

Conference Location

  • United States