PREDICTORS OF MORTALITY, MORBIDITY, AND DISABILITY IN A COHORT OF INFANTS LESS-THAN-OR-EQUAL-TO-28-WEEKS GESTATION

This study attempted to identify predictors for mortality, morbidity, disability, and educational handicap at age 4 years in a cohort of 194 infants born at 23 to 28 weeks' gestation at one regionalized tertiar y center from 1983 to 1986. Forty-one infants died (21%); standardized neurodevelopmental and functional assessments were conducted on 149 o f 153 (97%) survivors at a mean age of 52 months. Five significant pre dictors of death were identified with logistic regression analysis: ge stational age 23 to 26 weeks, intraventricular hemorrhage grades 3 or 4, male gender, five-minute Apgar less-than-or-equal-to 3, and absence of prophylactic calf lung surfactant extract. Significant predictors of neurodevelopmental morbidity included sepsis, male gender, and nonw hite race. Significant predictors of disability at age four included n eurodevelopmental impairment and severe retinopathy of prematurity. Lo w socioeconomic status, nonwhite race and male gender were predictive of educational handicap. These findings suggest that outcomes may have distinct pathophysiologies. The role of biomedical events appears str ongest for death.