Article,

Early assessment and neurodevelopmental outcome in very low-birth-weight infants: implications for pediatric practice.

, , and .
Acta Paediatr, 82 (5): 449--453 (May 1993)

Abstract

To determine which assessments are useful, at what age, in order to identify handicaps in very low-birth-weight infants, neonatal cerebral ultrasound findings, neurological examinations and the mental scale of the Bayley Infant Scales of Development at 1 and 2 years of age were examined in relation to neurodevelopmental outcome at 3.6 years of age in a cohort of 79 high-risk very low-birth-weight infants. At 3.6 years of age, a minor handicap was found in 9 (11\%) and a major handicap in 4 (5\%) children. Cerebral palsy was found in 9 (11\%) children at 3.6 years of age and could only be diagnosed reliably at 2 years of age. For short-term follow-up, as feedback to the neonatologist, the positive predictive value of intraparenchymal damage, as detected by neonatal cerebral ultrasound, was greater than the positive predictive value of a definitely abnormal neurological examination at 1 year of age. Visual handicaps (n = 4, 5\%) and severe hearing deficits (n = 1, 1\%) were all detected in the first year of life. A mental handicap was found in 7 (9\%) children. It was impossible to predict mental handicaps for the individual child. Only 35\% of the children with a mental delay at 2 years of age had a mental handicap at 3.6 years of age, whereas 35\% had a normal cognitive outcome. Pediatricians therefore should be cautious in the interpretation of developmental test results in infancy. Long-term follow-up is essential for the child and its parents.

Tags

Users

  • @ar0berts

Comments and Reviews