Two-year outcome of infants weighing 600 grams or less at birth and born 1994 through 1998

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Abstract

OBJECTIVE: To assess the neurologic and developmental outcome at 2 years of age in preterm infants with birth weights 600 g or lower. METHODS: We conducted a retrospective review from January 1994 through December 1998 for placental histopathology, maternal factors, neonatal intensive care unit course, growth, neurologic/special sense status, and development at 2 years of age corrected for prematurity. RESULTS: Of the 104 neonates weighing 600 g or less, 24 survived to nursery discharge (23%). Two infants died of chronic lung disease after discharge, and 21 of the remaining 22 infants (95%) returned for follow-up. Placental pathology was available for 21 (95%); acute inflammation was present in 67%, and other abnormalities occurred in 76%. Mean birth weight was 537 (430-600) g, and mean gestational age was 24 (22-27) weeks. At birth, 55% were below the tenth percentile for birth weight. At nursery discharge and 2 years of age, 94% were below the tenth percentile for weight, length, and head circumference. Nineteen of 21 (90%) infants were abnormal on neurodevelopmental follow-up. Major problems were cerebral palsy, blindness, gastrostomies, and ventriculoperitoneal shunts. CONCLUSION: Abnormal placental histology was present in all but one infant, suggesting fetal injury before birth. Only eight of 20 infants with chorioamnionitis were diagnosed clinically, and all infants had a complicated course. We found a high incidence of intrauterine growth restriction and an almost universal pattern of impaired postnatal growth with extremely poor neurodevelopmental outcome at 2 years of age. © 2003 by The American College of Obstetricians and Gynecologists.

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Sweet, M. P., Hodgman, J. E., Pena, I., Barton, L., Pavlova, Z., & Ramanathan, R. (2003). Two-year outcome of infants weighing 600 grams or less at birth and born 1994 through 1998. Obstetrics and Gynecology, 101(1), 18–23. https://doi.org/10.1016/S0029-7844(02)02451-1

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