THE OUTCOME AT 12 MONTHS OF VERY-LOW-BIRTH-WEIGHT INFANTS VENTILATED AT TYGERBERG-HOSPITAL

Objective. To determine the outcome at 1 year of age of a group of vel y-low-birth-weight (VLBW) infants, from urban and rural communities, v entilated at Tygerberg Hospital, W. Cape. Study design, Prospective de scriptive study in which the prevalence of bronchopulmonary dysplasia (BPD), sensorineural deafness, intraventricular haemorrhage (IVH), ret inopathy of prematurity (ROP) and abnormal motor developmental outcome s were determined in 153 ventilated VLBW infants from rural and urban areas, Of these, 69% were from lower socio-economic backgrounds, Main outcome measures, Attrition rates for rural and urban babies, BPD, ROP , IVH and abnormal motor development, Study population and setting, Al l ventilated VLBW infants discharged from the neonatal intensive care unit at Tygerberg Hospital over a l-year period were followed up at 3- monthly intervals for 12 months, Results, BPD was diagnosed in 19% of the babies, with significantly more babies with birth weights under 1 000 g and gestational ages under 28 weeks having BPD, Of the babies wi th BPD, 25% had abnormal motor development at 1 year of age. Seven per cent of the babies had grade 3 or 4 ROP and 2,6% had sensorineural he aring loss, One hundred and seventeen (79%) of the infants attended th e follow-up clinic until 12 months of age (corrected for prematurity), There were no significant differences in the number of babies followe d up from rural or urban areas. Fourteen (11,9%) of the babies had abn ormal motor development, A disturbing finding was that so many babies had spastic quadriplegia (8; 57%) versus diplegia (6; 43%). The incide nce of abnormal motor development in the babies from the rural areas a nd in those with birth weights under 1 000 g from rural areas was high - a further cause for concern. Conclusion. The prevalence of the majo r complications associated with ventilated VLBW infants correlated wel l with those reported for similar infants from First-World countries. The poor motor developmental outcome of the babies from rural areas wi th birth weights under 1 000 g and high attrition rates for infants wi th serious complications such as BPD, IVH and ROP are distressing.