Ba. Darlow et al., Regional differences in outcome for very low-birthweight infants: Do they persist at 7-8 years of age?, J PAEDIAT C, 36(5), 2000, pp. 477-481
Objective: To determine whether regional differences in early neonatal morb
idity in a national cohort of very low-birthweight (VLBW) infants persisted
at 7-8 years of age.
Methods: Perinatal data collected prospectively from birth on all VLBW infa
nts born in New Zealand in 1986 and admitted to a neonatal unit included th
e hospital principally caring for the infant: hospitals A-D being level III
hospitals and 'Other' including the smallest level III and all level II ho
spitals. At 7-8 years of age, 298 surviving children (96% survivors living
in New Zealand) were assessed at a home visit. Parents were given a compreh
ensive questionnaire to complete, the children underwent a visual examinati
on and were tested with the Revised Wechsler Intelligence Scale for Childre
n and the child's teacher was sent a questionnaire to complete.
Results: Neonatal survival was significantly greater in the two largest hos
pitals (A and B) and this difference in survival remained at 7-8 years of a
ge after adjustment for perinatal factors (P < 0.05). There were no differe
nces between hospitals in risks of long-term sensorineural disability and b
ehavioural or educational outcomes. There were interhospital differences in
rates of visual problems and, after adjustment for confounding factors, th
ere remained a marginally significant (P = 0.06) increased risk of myopia i
n hospital D.
Conclusions: Despite differences in early morbidity favouring larger hospit
als, there were no substantive differences in long-term (7-8 years) outcome
s across a range of measures in this national cohort of VLBW infants.