Cerebral palsy (CP), the predominant neurologic problem of VLBW (<1.5 kg) children, occurred in 50/839 (6%) of our VLBW inborn singleton survivors during 1983-1991.

We sought to examine the development at 20 months corrected age of all 50 singleton VLBW infants (BW 1014 g, GA 28 wks, 54% male) diagnosed with CP born at our center from `83-'91 compared to VLBW infants without CP (BW 1029 g, GA 28 wks), matched by bwt (± 250 g), gest. age (± 2 wks), race and sex to the next child without neurosensory impairment at 20 months. Social risk as determined by marital status, race and maternal education were similar.

Of the children with CP, 37 had spastic diplegia and/or hemiplegia and 13 had quadriplegia. No quadriplegic children and 17/37 (46%) with di/hemiplegia were ambulatory at 20 months. The Bayley Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) were performed at 20 months. The effects of grd 3-4 IV bleed, sepsis and BPD were examined.Table

Table 1
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Multivariate analysis revealed that social risk and BPD had independent effects on the MDI above and beyond the effect of CP (social risk p<0.005; BPD p<.01), while severe IV bleed and sepsis had an additional effect on PDI but not MDI (IV bleed p<.005; sepsis p<.05).

We conclude that only 22% of VLBW infants with CP have a normal MDI. Whereas infants with diplegia have a broad spectrum of outcomes, those with quadriplegia all have severe delay.