Neurosensory outcome and growth at three years in extremely low birthweight infants: follow‐up results from the Swedish national prospective study

Abstract

A prospective national investigation comprising 633 extremely low birthweight (ELBW) infants born alive in the 2‐y period 1990‐1992 with a birthweight of ≤ 1000 g and gestational age of ≥ 23 completed weeks was conducted regarding neurosensory outcome and growth. Three‐hundred and sixty‐two (98%) surviving ELBW infants were assessed at a median age of 36 months, using a specially designed protocol. At follow‐up, mean height, weight and head circumference in both boys and girls were significantly lower than the reference values. The incidence of cerebral palsy was 7% among all children and 14%, 10% and 3% in children born at 23‐24,25‐26 and ≥ 27 gestational weeks, respectively. At least one obvious handicap was present in 14%, 9% and 3% of these three groups of children, respectively. After adjustment for gestational age, a significantly increased risk of handicap was found in children with intraventricular haemorrhage grade ≥ 3 and/or periventricular leucomalacia and in children with retinopathy of prematurity stage ≥ 3. The results show that more than 90% of ELBW children born at ≥ 25 completed gestational weeks were without neurosensory handicap at 36 months of corrected age. In infants born at 23–24 weeks of gestation, both survival and long‐term outcome were less favourable.