IMPROVED OUTCOME TO TWO YEARS OF VERY LOW‐BIRTHWEIGHT INFANTS: FACT OR ARTIFACT?

In 1966‐70, the survival rate for very low‐birthweight (VLBW) children born in a tertiary perinatal centre was 37–1 per cent but by 1980‐82 it had increased to 68‐3 per cent. The latter cohort had a significantly reduced prévalence of strabismus, myopia and a head circumference under the 10th percentile, but a significantly increased prévalence of cerebral palsy compared with the 1966‐70 VLBW children. Survivors born in 1980‐82 had a significantly increased mean Mental Development Index (MDI) on the Bayley Scales compared with the sub‐group of survivors born in 1968‐70 but there was also a significant improvement in mean MDI over time for a group of normal‐birthweight children. No improvement of MDI scores of VLBW survivors in the 1980‐82 cohort could be attributed solely to perinatal care. The two‐year‐old VLBW children in the 1980‐82 cohort had similar rates of sensorineural impairments, disabilities and mean MDI to those who would have survived with the care available in 1966‐70. It is concluded that survival of VLBW infants has improved in recent times but that neurodevelopmental outcome still lags behind that of normal‐birthweight peers.

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