DEVELOPMENTAL OUTCOME AT 12 MONTHS CORRECTED AGE FOR INFANTS BORN LESS-THAN 30 WEEKS GESTATION - INFLUENCE OF REDUCED INTRAUTERINE AND POSTNATAL-GROWTH
C. Wocadlo et I. Rieger, DEVELOPMENTAL OUTCOME AT 12 MONTHS CORRECTED AGE FOR INFANTS BORN LESS-THAN 30 WEEKS GESTATION - INFLUENCE OF REDUCED INTRAUTERINE AND POSTNATAL-GROWTH, Early human development, 39(2), 1994, pp. 127-137
Infants born at less than 30 weeks gestation were prospectively follow
ed to examine the consequences of size at birth and subsequent growth
on development in the first year of life. A total of 438 infants were
admitted to the intensive care nursery; 53 (12.1%) infants were small
for gestational age (SGA). A total of 315 infants survived to discharg
e; 19 (6%) were SGA. SGA infants were matched with appropriate for ges
tational age (AGA) infants for sex, GA, incidence of chronic lung dise
ase and head ultrasound at discharge. The high death rate amongst SGA
infants was attributable to a combination of extreme prematurity and i
nappropriate intrauterine growth. There was no difference between SGA
and AGA groups for major developmental disability at I-year corrected
age. The effect of subsequent growth on development was examined by co
mparing children in the cohort above (Appropriate) and below (Small) t
he 10th percentile for weight at 1 year. Children small at 1 year had
a significantly higher rate of major developmental disability at I yea
r. Perinatal variables demonstrate that those infants small at 1 year
had been of significantly younger GA; lighter BW, had received more ve
ntilator and oxygen therapy. They also had a higher incidence of chron
ic lung disease. Thus, being born SGA at less than 30 weeks is not of
itself associated with increased disability at 1 year when other confo
unding factors are taken into account. While a causal link has not bee
n established, poor growth in the first year of life does appear to be
associated with poorer outcome at 1 year, irrespective of birth statu
s.