Extremely low–birth–weight infants less than 901 g: development and behaviour after 4 years of life

Abstract

In a long-term, prospective, control study, 20 extremely low-birth-weight (ELBW) infants with birth weights between 500 and 900 g (mean 755 (SD 109) g) and gestational ages between 24 and 30 weeks (mean 26.2 (SD 1.8) weeks) were compared with 20 full-term infants at 4 years of age for growth, health, development and quality of life. Four of 20 (20%) ELBW children had major neurological disorders, which were all identified at the 1-year assessment. Seventeen (85%) ELBW children had cognitive development, assessed with the Griffiths mental development scale, within the normal range for age but lower than for full-term controls. The greatest deviations between ELBW and full-term children were found in locomotor and visual-motor integration functions. Eight ELBW children in all (40%), four with recurrent respiratory tract infections after neonatal mechanical ventilation and the four children with major neurological disorders had a higher rate of visits to physicians and hospital admissions. The behavioural symptom interview showed an increased rate of hyperactivity and difficulties in concentrating but not of general behavioural deviations in the ELBW group. Only by school age can all aspects of an extremely early birth be evaluated, but at 4 years of age, 85% of the ELBW children in our group had a good quality of life according to Scheffzek's categorizations.

Desenvolvimento cognitivo de crianças prematuras de muito baixo peso na idade pré-escolar

“…These results are worse than those reported in the literature, which show lower mean IQ values in the group of very-low-birthweight preterm infants, but within normal limits. 2,[12][13][14][15] In our group, the mean results ranged from 65 to 89 points in the different scores proposed by the test (total, verbal and performance). This means that these childrens intellectual functioning was close to being deficient, at the time of evaluation.…”

Desempenho motor em recém-nascidos pré-termo de alto risco

“…Conseqüentemente, tem aumentado o interesse sobre a investigação da qualidade de vida e a morbidade desses recém-nascidos 1,2 .…”

Pre-school cognitive development of very low birth weight preterm children

“…Estes resultados são piores do que os relatados na literatura, que mostram médias mais baixas de QI nos grupos de crianças prematuras de muito baixo peso, porém dentro da faixa de normalidade 2,[12][13][14][15] . Em nosso grupo, a média dos resultados alcançados variou de 65 pontos até 89 pontos nos diferentes escores propostos pelo teste (total, verbal e executivo).…”