SUMMARY The effects of prenatal, perinatal and postnatal events on developmental outcome at five to seven years of preterm infants with birthweights appropriate for gestational age were investigated in two separate cohorts: one a longitudinal study of 97 infants, the other a cross‐sectional study of 249 infants. Among the prenatal variables, the number of minor congenital anomalies was negatively correlated with neurological development, as was the deformation score. The pregnancy optimality score was not significantly related to outcome. Among the perintal variables, gestational age and birthweight had some significant correlations with development, but birth and neonatal optimality scores were only inconsistently significant in relation to outcome. Socio‐economic status was strongly related to language and intellectual development. Infants with gestations of 32 to 36 weeks had a more favourable neurological and intellectual outcome than those born before 32 weeks: however, the former group comprised about 80 per cent of the population studied, so the majority of children with lower function were found in that group. RÉSUMÉ Signification des facteurs prénataux, périnataux et postnataux dans le développement des prématurés à poids normal pour le terme, à cinq et sept ans Les effets d'évènements prénataux, périnataux et postnataux sur le devenir du développement à cinq et sept ans, de prématurés de poids normal pour le terme ont été répartis en deux cohortes séparées: l'une pour une étude longitudinale de 97 nourrissons, l'autre pour une étude transversale de 249 nourrissons. Pour les variables prénatales, le nombre d'anomalies congénitales mineures était relié negativement avec le développement neurologique, comme le score de déformation. Le score d'optimalité de grossesse n'était pas relié statistiquement au devenir. Parmi les variables périnatales, l'âge de gestation et le poids de naissance étaient faiblement reliés au devenir, mais les conditions de naissance et le score d'optimalité néonatale n'étaient pas liées significativement au devenir. Le statut socio‐économique était fortement relié au développement du langage et de l'efficience intellectuelle. Les enfants nés après une grossesse de 32 à 36 semaines avaient un devenir neurologique et intellectuel plus favorable que ceux nés après une grossesse de moins de 32 semaines: cependant le premier groupe contenait environ 80 pour cent de la population étudiée si bien que la majorité des enfants à fonctions altérées se trouvait dans ce groupe. ZUSAMMENFASSUNG Signifikanz von prä‐, peri‐ undpostnatalen Faktoren für die Entwicklung von AGA‐Frühgeborenen im Alter von fünf bis sieben Jahren Die Auswirkungen prä‐, peri‐ und postnataler Faktoren auf die Entwicklung im Alter von fünf bis sieben Jahren von Frühgeborenen mit dem Gestationsalter entsprechenden Geburtsgewichten wurden in zwei Kohorten untersucht: in einer Longitudinalstudie von 97 Kindern und in einer Kreuz‐Teilstudie von 249 Kindern. Bei den pränatalen Parametern waren die Anzahl geringfügiger kongenit...

ABSTRACT. Estimations of cerebral blood flow were performed by both near infrared spectroscopy and 133xenon clearance on 12 occasions in nine critically ill premature infants (26-29 gestational wk) who required mechanical ventilation and supplemental oxygen. For each study, one determination of cerebral blood flow by '33xenon was compared with the mean of two to five measurements by near infrared done within 1-19 (median 5) h. 133Xenon measurements ranged from 9.6-16.9 mL/100 g/min, and mean near infrared measurements ranged from 8.6-25.0 mL/100 g/ min. There was a significant correlation between the two sets of measurements (r = 0.80, p < 0.001). The mean difference between the methods was 1.6 mL/100 g/min, and the 95% limits of agreement were -0.5-3.8 mL/100 g/min. This study showed that cerebral blood flow can be measured noninvasively in critically ill premature infants at the cotside by near infrared spectroscopy and by the '33xenon clearance technique. Hypoxic-ischemic brain injury is a major cause of long-term neurodevelopmental disability in newborn infants-especially in very immature ones-who survive after intensive care. Impaired CBF may be an important factor in the pathogenesis of this type of cerebral injury. However, the exact mechanism is still unknown. Noninvasive quantitative techniques are therefore required to investigate the role of CBF in the pathogenesis of this condition.There are several methods that could be used to quantify CBF in the neonate: venous occlusion plethysmography (I), positron emission tomography (2), XeC, and NIRS. XeC and NIRS can both be applied at the cotside with minimal interference with care and were selected for comparison in this study. The purpose

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Intellectual development, speech and school performance of preterm infants with birth weight appropriate for gestational age are reported in two separate investigations: a longitudinal study of 97 preterm children and 93 term children as a control group, and a cross-sectional study of 249 preterm children. Both preterm groups were regarded as high risk groups with respect to number of outborns, distribution of gestational age and perinatal risk factors. Intellectual outcome at 5 and 7 years of age in the majority of the preterm children was comparable to that of the term children. However, 8% of the preterm boys and 2% of the preterm girls achieved lower IQ scores than any of the term children. Between 15% and 17% of the preterm boys and 9%-12% of the preterm girls did not attend school at grade level, compared to 4% and 2% in the term group, respectively. Intellectual and neurological development and school performance were higher interrelated in the preterm than in the term children. Articulation defects, stuttering and dysgrammatism occurred more frequently in the preterm than in the term children and in boys more so than in girls.

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