Preschool Outcome of Less Than 801-Gram Preterm Infants Compared With Full-Term Siblings

Extremely low birth weight (ELBW) infants are at greater risk for neurodevelopmental delay than full-term infants. Outcomes may be compromised secondary to abnormal brain development associated with complications of prematurity. Long-term cognitive outcome has also been reported to be significantly...

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Bibliographic Details
Published in:	Pediatrics (Evanston) Vol. 113; no. 4; pp. 742 - 747
Main Authors:	Kilbride, Howard W, Thorstad, Karla, Daily, Donna K
Format:	Journal Article
Language:	English
Published:	Elk Grove Village, IL Am Acad Pediatrics 01-04-2004 American Academy of Pediatrics
Subjects:	Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Babies Biological and medical sciences Birth weight Child Development Child development deviations Child Language Child psychopathology Child, Preschool Childhood mental disorders Developmental disabilities Developmental Disabilities - diagnosis Developmental Disabilities - epidemiology Diseases of mother, fetus and pregnancy Emergency and intensive care: neonates and children. Prematurity. Sudden death Female Follow-Up Studies General aspects Gynecology. Andrology. Obstetrics Health aspects Humans Infant, Newborn Infant, Very Low Birth Weight Infants Intelligence Intelligence Tests Intensive care medicine Male Medical sciences Motor Skills Pediatrics Physical growth Pregnancy. Fetus. Placenta Premature birth Psychomotor Performance Siblings Socioeconomic Factors United Kingdom Premature Pediatrics Vocabulary standard deviation; Cl Prognosis Socioeconomic status Pregnancy disorders Peabody Picture Vocabulary Test; TACL Infant Standard developmental outcome Sibling Preschool Language Scale; PPVT preschool testing Very low birthweight Language Auditory Comprehension Language Test Development Evolution socioeconomic status. nomic status; SB Stanford-Binet; PMQ Human Preschool age psychomotor quotient; PLS Low birth weight Exploration Medical screening Long term Test of Auditory Comprehension of Language; SD Standards Confidence interval Newborn diseases Prematurity Follow up study Deviation Comparative study
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Summary:	Extremely low birth weight (ELBW) infants are at greater risk for neurodevelopmental delay than full-term infants. Outcomes may be compromised secondary to abnormal brain development associated with complications of prematurity. Long-term cognitive outcome has also been reported to be significantly influenced by postnatal factors. The objective of this study was to clarify the effects of prematurity separate from environmental factors on growth and neurodevelopmental outcomes by comparing ELBW children with their full-term siblings. The study consisted of 25 ELBW children, a subset selected from a larger population of infants who were <801 g birth weight and enrolled in a longitudinal follow-up project from birth and their 25 full-term, full-weight siblings. Twenty-three sets of siblings were evaluated at 5 years of age and 2 sets at 3 years of age with standardized medical, social, cognitive, motor, and language testing. Physical and neurodevelopmental outcomes were compared between groups, controlling for gender and socioeconomic status (SES). At follow-up, ELBW children were lighter, were shorter, and had smaller head circumference. The ELBW children had lower Stanford-Binet IQs (85 +/- 12 [mean +/- SD] and 95 +/- 11), with lower Stanford-Binet subtests except short-term memory and quantitative reasoning, lower spelling scores on the Wide Range Achievement Test, and lower Peabody motor quotients (79 +/- 11 and 92 +/- 17). Preschool Language Scale quotients were not different, but other receptive language measures were lower for ELBW children. High SES seemed to modify the impact of preterm status on cognitive and language but not motor scores. The mean IQ for high-SES ELBW children was equivalent to that of the low-SES term siblings. Preschool-age cognitive and language functioning in ELBW children seemed to be affected by both prenatal and birth influences (preterm status) and postnatal influences (SES variables). Motor scores were significantly related to preterm status but not to SES.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0031-4005 1098-4275
DOI:	10.1542/peds.113.4.742