Outcome at school age of children with birthweights of 1000 grams or less.

A follow-up study was done of extremely low-birthweight infants (less than or equal to 1000g) born between 1976 and 1979, a period when aggressive intervention was not routine practice. The survival rate was 19 per cent. 44 of the 46 survivors were followed to a mean age of 6 1/2 years. By five years of age 23 of the 44 children had been admitted to hospital, mainly for surgery and respiratory problems. Eight of 31 five-year-old children were growth-retarded and five of 26 were microcephalic. Among 44 children, ophthalmological problems were found in nine cases and neurosensory impairments (cerebral palsy, deafness) in seven. 12 children were mentally handicapped or had impaired intelligence (IQ or DQ less than 85). Over-all, 14 of the 44 children had impairments, severe in four cases and moderate in 10. Mean verbal IQ was significantly lower than mean performance IQ. Among 37 children in school or in remedial programs, nine required special education and another 12 in regular classes either failed or had very poor results, or needed extra professional help. Only 16 of the children had no significant problems in school. These findings indicate that extremely low birthweight (less than or equal to 1000g) represents a major risk to life, health (hospital admissions), long-term growth, neurosensory integrity, cognitive development and learning potential.