89 Growth, Motor Skills and Intellectual Development Between 9 and 15 Years of Age in Very Low Birthweight Children and Controls

Abstract

Background: Several scoring systems have been developed for assessing the condition of the newborn infant at birth and for predicting mortality and morbidity. Apgar scores are generally used for evaluation of preterm infants although their predictive value has been debated.Aim: To investigate whether Apgar scores and the clinical risk index for babies (CRIB) can predict short-term outcome in extremely preterm infants cared for with an active management strategy. Method: Prospectively recorded data in a regional perinatal database were investigated for the time-period 1995-2001 (nϭ 108000 births). Short-term outcome variables included mortality and severe intracranial pathology (IVH grade 3-4 or cystic PVL). Ninety-two liveborn infants, and five stillborn infants, with gestational age 25ϩ0 to 25ϩ6 weeks were identified in the register. Ten infants died within the first week of life, and 10 died later. Among the non-survivors were three infants with congenital malformations. Seventy-two infants were alive at a postnatal age of 180 days, 6 of these infants had IVH grade 3-4 or PVL. Four of the surviving infants were excluded from further analysis due to inappropriate Apgar scores.Results: Apgar scores at 1, 5 and 10 minutes were significantly correlated with survival without severe intracranial pathology (pϭ0.016, 0.003, and 0.003, respectively). The strongest model for predicting survival without severe intracranial pathology was created from 5-minute Apgar scores and the CRIB-score (pϭ0.000). Survival without severe intracranial pathology was higher in single versus multiple births (pϭ0.030), but was not associated with infant gender (pϭ0.407), or mode of delivery (pϭ0.479).Conclusion: Apgar scores, already at 1 minute after birth, are highly predictive of outcome in extremely preterm infants with gestational age 25 weeks. The accuracy of the prediction of outcome increases when the Apgar scores are combined with CRIB-scores. Background: Few follow up studies of Very Low Birthweight (VLBW) children are conducted longitudinally. We have performed repeated follow up examinations of a cohort of VLBW children and their controls. At 9 years of age the VLBW children lagged behind in anthropometric measurements, but also in academic achievements. The aim of this study was to investigate whether the differences noted at 9 years persisted at 15 years of age. GROWTH, MOTOR SKILLS AND INTELLECTUAL DEVELOPMENT BETWEEN 9 AND 15 YEARS OF AGE IN VERY LOW BIRTHWEIGHT CHILDREN AND CONTROLSMethods: This is a population based study including all surviving VLBW children (nϭ86) born during a 15 month period in 1987 to 1988 within the Southeast region of Sweden and normal birth weight controls (nϭ86). The following assessments and tests were performed: anthropometric measurements, state of puberty, motor skills (Bruininks-Oseretsky test), intellectual ability (Raven's matrices at 9 years, Wechsler Intelligence Scale for Children; WISC-III at 15 years of age), reading ability and word decoding skills.Results: Three children with cerebr...