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Two-year neurodevelopmental outcome of preterm born children ≤750 g at birth
  1. M J Claas1,
  2. H W Bruinse1,
  3. C Koopman2,
  4. I C van Haastert2,
  5. L M Peelen3,
  6. L S de Vries2
  1. 1Department of Obstetrics and Gynaecology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, the Netherlands
  2. 2Department of Neonatology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, the Netherlands
  3. 3Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
  1. Correspondence to M J Claas, Department of Obstetrics and Gynaecology, University Medical Centre, Wilhelmina Children's Hospital, KE 04.123.1, PO Box 85090, Utrecht 3508 AB, the Netherlands; m.j.claas{at}umcutrecht.nl

Abstract

Objectives To describe 2-year neurodevelopmental outcome (NDO) in a cohort of extremely low birthweight infants, and compare NDO between two consecutive 5-year periods and between appropriate (AGA, ≥p10) and small for gestational age (SGA, <p10) infants.

Design Retrospective cohort study.

Setting Wilhelmina Children's Hospital, Utrecht, the Netherlands.

Patients 146 children, born between 1996 and 2005, with a birth weight ≤750 g and a gestational age ≥24 weeks, admitted to the neonatal intensive care unit. 111 children (76%) survived the neonatal period.

Interventions At 2 years corrected age, 101 children (cohort I: born in 1996–2000, n=45 and cohort II: born in 2001–2005, n=56) were assessed with either the Griffiths Mental Developmental Scales or the Mental Scale of the Bayley Scales of Infant Development, second edition.

Main outcome measures NDO, classified as normal (≤−1 Z score ≥0), mildly delayed (>−1 Z score ≤−2) or severely delayed (Z score >−2).

Results 74.3% of the children had a normal NDO at 2 years corrected age, 20.8% a mildly and 5% a severely delayed outcome. Although survival significantly increased with time (65.8% to 88.1%, p=0.002), significantly fewer children in cohort II (66.1% vs 84.4% in cohort I, p=0.042) as well as fewer SGA children (64.3% vs 86.7% of AGA children, p=0.012) had a normal NDO.

Conclusions Increased survival of infants with a birth weight ≤750 g coincided with more children with an impaired NDO at 2 years corrected age. SGA infants are especially at risk of impaired NDO.

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Footnotes

  • Funding None.

  • Competing interest None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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