THE LONG-TERM NEURODEVELOPMENTAL OUTCOME FOR VERY-LOW-BIRTH-WEIGHT (VLBW) INFANTS WITH DYSTONIC SIGNS AT 4 MONTHS OF AGE

As very low birthweight (VLBW) infants are at a high risk of developme ntal handicap, it is important to establish predictors of long-term ad verse outcome at an early age so that early intervention can be instit uted. Longitudinal neurodevelopmental assessments were performed in 10 7 VLBW infants at 1,4, 8 and 12 months corrected age. Eighteen were di agnosed as 'dystonic' at 4 months of age. This study compared the outc omes at 4 and 6 years for 15 of the 18 dystonic with 75 of the 89 non- dystonic VLBW infants, respectively. At 9 years of age, nine dystonic and 54 non-dystonic infants were assessed on the Rutter Behaviour Ques tionnaire. Dystonic children had a lower mean General Cognitive Index (GC; P = 0.001) and a higher incidence of disability as measured by th e Burns Neuro-Sensori-Motor Developmental Assessment Scale (P = 0.0005 ) and Kitchen disability grading (P = 0.001). Even if the minor neurol ogical aberrations of the premature dystonia syndrome in VLBW infants abate by one year of life, these infants still constitute a high-risk group for subsequent neurodevelopmental disability and therefore requi re close observation and probably early intervention.