Out of all 1024 admissions of very low birth weight (VLBW) neonates to 6 regional NICUs during 8/1/88-6/30/91, 820 survived to age 5. Out of 634 with re-contact information, a representative group of 425 were located and parents interviewed. Functional assessment was performed by trained and monitored nurses using the PEDI (Pediatric Evaluation of Disability Inventory), which is age standardized to normative mean of 50 and standard deviation (SD) of 10 on three scales: self care, mobility and social functioning. Demographic information, neonatal characteristics and birth date 8/1/88-7/31/89(T1:pre-surfactant) 8/1/89-7/31/90 (T2:IND period for Exosurf) and 8/1/90-6/30/91 (T3:Exosurf released) were examined as predictors.. Means (SD) among children without CP were 47.4 (11.9), 43.2 (14.7) and 44.0 (11.8); respectively; among those with CP they were 26.7 (14.6), 15.1 (11.1) and 34.5(14.3). CP incidence did not change across T1-T3 (13%, 11%, 12%, p=.71). The table shows differences obtained by regression analyses. Models were adjusted for interviewer, timeliness of interview relative to the target age of 5 and birth weight. We conclude that functional status of VLBW children is determined by both dernographic variables and neonatal morbidity, including IVH and respiratory disease. Social function may be lower among children born in the post-surfactant era. More extensive analyses showed this drop to be at least partly explained by neonatal morbidity subsequent to the survival of smaller, sicker neonates (mean birth weights were in T1: 1146g and in T3: 1077g, p<0.05).

Table 1 Effect of predictors among children without CP
Full size table