OUTCOME OF VERY-LOW-BIRTH-WEIGHT INFANTS IN INDUSTRIALIZED COUNTRIES - 1947-1987

Neonatal intensive care has led to a progressive improvement in the su rvival of very low birth weight (VLBW, <1,500 g) infants. However, it has not been established whether there has been a simultaneous increas e or decrease in the prevalence of handicapping conditions in this gro up of children. To explore this question, a meta-analysis was performe d using outcome data of 32 developmental studies of VLBW infants born in industrialized countries between 1947 and 1987. The authors' result s show that the proportion of VLBW infants who survived and had an int act outcome progressively increased between 1947 and 1987-from 147 per 1,000 live births in the period 1947-1965 to 498 per 1,000 in the per iod 1980-1987 (p < 0.01). The prevalence of major handicapping conditi ons for the subset of VLBW infants who weighed <1,000 g at birth incre ased, resulting from the increasing survival rates. However, the preva lence of major handicapping conditions among all children with VLBW de creased from 147 per 1,000 live births in 1947-1965 to 45 per 1,000 in 1980-1987 (p = 0.02). The authors' meta-analysis suggests that improv ed survival of VLBW infants has not been accompanied by an increase, b ut more likely a decrease, in the prevalence of handicapping condition s in this birth weight group.