Development of former preterm infants with a birthweight below 1500 g: concept and results of a follow-up programme up to school age in Central Switzerland

Aim: To document the psychomotor development and general health of former v ery low birthweight infants born between 1980 and 1986 from birth up to sch ool age. We wished to evaluate the quality of neonatal intensive care in Ce ntral Switzerland over this time period and test the reliability of a patie nt-oriented fellow-up programme. If successful, the latter could perhaps se rve as a model for a national follow-up programme in Switzerland. Methods: Information regarding three different developmental periods was co llected. The medical records of the perinatal period were used to abstract details of labour and delivery and the neonatal period. The records of the infant follow-up programme were used to describe psychomotor development be tween 0 and 24 months of age. The current health status and school performa nce were evaluated using a questionnaire sent to parents and teachers. Results: Of 139 infants born with a birthweight of less than or equal to 15 00 g, 102 were discharged home (mortality rate 26.6%). One third was not sc reened for hearing deficits or retinopathy of prematurity. Eighty-two were seen in the infant follow-up programme between 0 and 24 months of age. Seve nty-seven percent of these infants were judged to be normal and discharged from the infant follow-up programme; 1/5 of these infants had had transient motor problems treated by physical therapy. Twenty-three percent of the in fants seen in infant follow-up had persistent but mainly minor motor handic aps, and only two infants (2%) had multiple handicaps. At school age, data from 99 of the 102 surviving infants was collected. Ninety-six percent atte nded regular school, but almost half of them had significant school problem s and required professional help. These problems correlated poorly with the results of examinations during early childhood (positive predictive value 67%). Conclusions: These long-term results of a population of preterm infants bor n in Central Switzerland in the 1980s are encouraging. To ensure completene ss of early ophthalmological and audiological examinations of all former sm all preterm infants, neonatal follow-up programmes should adhere to uniform guidelines.