Abstract
Background: Due to improvements in perinatal and postnatal care viability of preterm infants has increased tremendously during the last decades. Unfortunately, recent population based data about outcome of ELGA infants suggest that severe disability is high among survivors. From random follow-up visits we suggested better outcome of infants born at our centre since 2000. We therefore initiated this study to evaluate the neurodevelopmental outcome of these high risk children.
Methods: We assessed the outcome of all liveborn ELGA infants (GA <27 weeks) admitted during 2000, 2001, and 2002. Follow-up evaluation was performed starting 2/2004 and included a clinical and neurological examination, Bayley Scales of Infant Development II, and assessment of height, body weight, and head circumference.
Results: Overall, 71 ELGA infants were admitted. Birth weight ranged between 360g and 1300g (median 690g). Nineteen infants (27%) died before discharge (22wk: 0/2; 23wk: 6/7; 24wk: 6/17; 25wk: 4/18; 26wk: 3/27). Follow-up is completed in 33 (63%) of the 52 survivors (22wk: 2/2; 23wk: 1/1; 24wk: 8/11; 25wk: 9/14; 26wk: 13/24). Corrected age ranged from 10 to 42 months (median 28 months). MDI-Scores were >84 in 23, 84–70 in 4, and <70 in 5 infants. PDI-Scores were >84 in 24, 84–70 in 4, and <70 in 4 infants. One infant was blind, 12 had visual impairment, five required hearing aids. Height, body weight, and head circumference at follow-up were below 2 SD in 21%, 24%, and 33%, respectively. Overall, neurodevelopment was classified as normal in 20 of 33 (61%) infants (22wk:1/2; 23wk: 1/1; 24wk: 4/8; 25wk: 7/9; 26wk: 7/13).
Conclusion: In our centre, survival rates were 70% for ELGA infants born since 2000, but follow-up data still show a high rate of disability in survivors. 61 % were normal on follow-up at 10 to 44 months. Follow-up of all survivors will be done till July to allow a more definite statement on outcome.
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Kutz, P., Horsch, S. & Roll, C. 141 Outcome of Extremely Low Gestational Age (ELGA) Infants in A Single Centre. Pediatr Res 56, 488 (2004). https://doi.org/10.1203/00006450-200409000-00164
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DOI: https://doi.org/10.1203/00006450-200409000-00164