Normal and abnormal neurodevelopmental and behavioral outcomes of very low birth weight infants

Abstract

Advances over the past ten years in perinatal and neonatal management of very low birth weight (VLBW) infants (<1500 grams and <30 weeks’ gestation) have resulted in a significant increase in survival of fragile high risk infants, including those with extremely low birth weight (ELBW) (<1000 grams) [1–10]. Therapeutic advances including the use of antenatal steroids [3, 4], surfactant for respiratory distress syndrome [11, 12], prophylactic indomethacin for prevention of intra ventricular hemorrhage [13], improved nutritional management, and new ventilatory techniques [14] have all contributed to improved survival especially for infants with birth weights less than 1000 grams [5–10]. These high risk preterm survivors have increased complex neonatal medical morbidities affecting all organ systems including lungs, gastrointestinal tract, kidneys and brain, and post-discharge morbidities including increased growth failure, neurologic, developmental, cognitive, neuropsychological, functional and behavioral sequelae [15–25].