INFLUENCE OF OBSTETRIC MANAGEMENT ON OUTCOME OF EXTREMELY PRETERM GROWTH-RETARDED INFANTS

Aim-To describe the long term outcome of extremely preterm growth reta rded infants in relation to obstetric management and various perinatal events. Methods-A cohort study was undertaken in two tertiary care ce ntres with different obstetric management. All infants with fetal grow th retardation due to placental insufficiency and resulting in fetal d istress at 26 to 32 weeks of gestation, were included for the years 19 84-89. Main outcome measures were impairment, disability, or handicap at 2 years corrected age and at school age (4 1/2 to 10 1/2 years). Re sults-One hundred and twenty five (98%) were followed up until 2 years corrected age in the outpatient department; 114 (90%) were assessed a t school age. Impairments were found in 37% and disabilities or handic aps in 9% of the assessed infants, with no difference between centres. All disabled or handicapped children had already been identified by 2 years corrected age. Conclusions-Disability or handicap were related to neonatal complications (intracerebral haemorrhage or bronchopulmona ry dysplasia) and not to obstetric variables, thus making antenatal pr ediction impossible. The incidence of disability or handicap in these growth retarded infants was comparable with that of other preterm infa nts.