Reproductive, perinatal, and environmental variables as predictors of development of preterm (less than 1501 grams) and fullterm children at 5 years.

A risk index based on a variety of reproductive, perinatal and environmental variables was used to attempt to predict the developmental outcome of very low birthweight infants (birthweights under 1501 grams). Forty-one preterm infants and a demographically matched group of 42 fullterm infants were studied. The McCarthy Scales of Children's Abilities was administered to the children at 5 years of age. In general, the preterm children were delayed in the perceptual, memory, and motor abilities in comparison with the fullterm children. There were no significant differences between the AGA (appropriate for gestational age) and SGA (small for gestational age) preterm groups. Multiple regression and discriminant function measures were used to examine the overall relationship between the earlier measures and later development and to assess the risk for an individual child. The risk index was able to account for typically 30-40% of the variance associated with the 5 year scores and the prediction of an individual child's development was accurate for approximately 85% of the time. Severity of illness during the perinatal period, independently of social class and infant tests scores were the best predictors of outcome. This study demonstrates that developmental outcome can be predicted with a high degree of accuracy and a relatively simple system.