Analysis of development condition in infants with very low and extremely low birth weight after birth of one year

Abstract:

Objective：To investigate the middle-term and long-term prognosis of very low birth weight（VLBW） and extremely low birth weight（ELBW） infants after discharge through a systematic follow-up. Methods：A total of 218 VLBW（including ELBW） infants admitted in neonatal intensive care unit of our department from 03/2013 to 06/2017 were regularly returned to the follow-up clinic to take evaluations of physical development and nervous system development and accept individualized early intervention. Results：Among those 218 infants，25 were ELBW infants，the minimum gestational age was 25+6 weeks，and the minimum birth weight was （650） g；the average fetal age was （31.06±1.52） weeks，and the average birth weight was （1.27±0.18） kg. Follow-up to a corrected age of （14.53±2.36） months，height，body mass and head circumference lower than two standard deviations with same age and gender were 5.05%，5.50% and 2.65%，respectively. Mental development index（MDI） and psychomotor development index（PDI） were performed in accordance with the Bayley Scales of Infant Development，18 infants had MID and PDI scores≤69（8.26%），107 infants MID and PDI scores≥80（49.08%） and three infants（1.37%） were diagnosed with cerebral palsy. Grouped in terms of birth weight，MDI score in the ELBW group（n=25） was （74.84±13.30），which was significantly lower than that of （81.47±11.86） in the VLBW group（n=193）. Grouped in terms of gestational age，MDI score in the group with gestational age<28 weeks group was significantly lower than that in the other two groups（group with gestational age of 28-31+6 weeks and group with gestational age≥32 weeks）. In the group with abnormal MDI and PDI scores（score<70），incidence of abnormal cranial magnetic res－onance imaging（MRI） and intrahepatic cholestasis of pregnancy（ICP） was higher than that in the group with normal scores. Stepwise Logistic regression analysis was performed and showed that abnormal cranial MRI and ICP were risk factors for neurodevelopmental injury. Conclusion：ELBW/VLBW infants have a higher in－cidence of growth and developmental retardation；the smaller the gestational age is，the lower the birth weight is and the higher the in－cidence of neurodevelopmental delay is. Therefore，they need long-term and standardized follow-up and early intervention，to reduce serious complications and sequelae.