OUTCOME OF VERY-LOW-BIRTH-WEIGHT INFANTS - MULTIPLE GESTATION VERSUS SINGLETONS

Objective. Multiple gestation infants are overrepresented in intensive care nurseries, and have been reported to have greater morbidity than singletons. A cohort of very low birth weight infants was examined to determine outcome of premature infants based on gestation type (multi ple or single) and hypothesized that at this low birth weight, the out come of the groups would be similar. Method. The sample was composed o f all infants with birth weights less-than-or-equal-to 1250 g born in a 10-year period (September 1977 through September 1987). Ninety-two p ercent (n = 364) of the infants discharged were seen at 1 year of age, and 73% (n = 249) were observed to school age. Morbidity was assessed by neurodevelopmental examinations and standard developmental tests. Results. At 1 year of age and at school age, there were no differences in neurologic or neurosensory outcome between multiple gestation and single gestation infants. Logistic regression analyses were performed on the school age data, using cognitive outcome as the dependent varia ble and gestation type, birth weight, gestational age, intracranial he morrhage, chronic lung disease, and a social risk factor as predictor variables. Gestation type was not associated with cognitive outcome at school age. Social risk factors and chronic lung disease showed an as sociation with cognitive outcome at school age. Conclusions. Multiple gestation was not related to increased morbidity in this very low birt h weight group. The developmental outcome of all infants with birth we ights less-than-or-equal-to 1250 g in this study was related to medica l and social risk factors. These findings were consistent for a large group of infants over a 10-year period.