Neuropediatrics 2006; 37 - TP26
DOI: 10.1055/s-2006-945619

DEVELOPMENT OF VLBW PREMATURES IN THE SECOND YEAR OF LIFE

E Rodríguez 1, M Bellotti 1, S Liendo 1, S Napoli 1, MM Contreras 1, H Waisburg 1
  • 1Hospital de Pediatria Juan P. Garrahan, Capital Federal Buenos Aires, Argentina

Objectives: Describe the development of prematures at the age of 18 to 24 months, enrolled at the Service of Clinicas Interdisciplinarias of Garrahan Hospital and characterize those with cognitive delay and comorbilities.

Methods: Transversal retrospective study. Inclusion criteria: VLBW prematures born in the year of 2000 with development evaluations between the age of 18 and 24 months. Exclusion criteria: genetic syndromes, malformations and cardiopathy. Cognitive delay was defined as a Bayley exam <70 or CAT/CLAMS <80. Abnormal Motor evaluation was defined as Bayley motor <70 or in accord with neurologic examination. NBI, Unsatisfied Basic Necessities is an argentine official social economic parameter. Abnormalities in vision or audition exams were diagnosed by an specialist in the area. ANOVA was used for comparision of medias and Chi-square for categoric variables.

Results: 49 prematures were enrolled in the study with gestational age between 28.5±2.3 weeks and birthweight 1028±223 grams, 20 (40.8%) had Unsatisfied basic necessities (NBI). 14 (28.6%) had Intracranial hemorrhage grade III/IV; 2 (4.1%) had necrotizing enterocolitis (NEC); 11 (22.4%) had retinopathy of prematurity (ROP) and 37 (75.5%) had bronchopulmonary dysplasia. The Bayley exam was 67.5±16.1 and CAT/CLAMS was 77.47±17.28. 23/49 (46.9%) had Bayley <70 or CAT/CLAMS <80. Abnormality in auditive, vision and motor exams was 6 (26%), 5 (21.7%) and 13 (56.5%) respectively. There was a borderline statistic association between cognitive delay and ROP, NBI and number of morbilities=3 (P<0.06).

Conclusion: It is a small sample of very high risk children, because it is a third level reference hospital of Buenos Aires. The following factors were considered possible risk factors of cognitive delay in this population: ROP, considered as a proxy of quality of care in the intensive care; number of morbilities as an indicator of a high biological risk and NBI as a local parameter of socioeconomic status.