HEALTH AND NEURODEVELOPMENTAL OUTCOME AT 1-YEAR ADJUSTED AGE IN 508 INFANTS WEIGHING 700 TO 1100 GRAMS WHO RECEIVED PROPHYLAXIS WITH ONE VERSUS 3 DOSES OF SYNTHETIC SURFACTANT

A three-dose prophylactic regimen of synthetic surfactant replacement has been shown to improve neonatal and 1-year survival rates in infant s of 700 to 1100 gm birth weight when compared with a single prophylac tic dose, The purpose of this study was to evaluate the growth, develo pment, and late morbidity at 1 year adjusted age among the survivors o f the 826 patients enrolled in the protocol, Complete follow-up data w ere obtained for 75% of the survivors in both groups, Chronic lung dis ease, need for respiratory support, neurologic disease requiring medic ation, visual or auditory impairments, and the incidence and severity of retinopathy of prematurity were equivalent in the two groups, The f requency of neurodevelopmental impairment was also comparable in the g roups that received one dose versus three doses: moderate to severe ce rebral palsy was found in 9% versus 6%, mental retardation assessed by Bayley Scales of Infant Development scores less than 69 was found In 16% vs 14%, and moderate to severe impairments of any kind were found in 33% vs 24%, respectively, Furthermore, the absolute number of impai red survivors was 92 in the three-dose group versus 106 in the one-dos e group, despite a higher survival rate in the three-dose group, This study demonstrates that developmental outcomes of infants weighing 700 to 1100 gm who received three prophylactic doses of synthetic surfact ant are at least as good as those of infants receiving a single dose, and that improving survival rates of very premature infants with synth etic surfactant does not result in increased numbers of infants with i mpairments.