ABSTRACT
PIP: 761 infant weighing 1500 gms or less at birth were admitted to the Neonatal Intensive Care Unit at the Guatemalan Institute of Social Security between 1983-88. Cases with severe congenital or chromosomal anomalies were excluded. 386 infants survived this initial hospitalization. 150 completed 2 years and 65 completed 5 years of follow-up at a special multidisciplinary clinic. Follow-up visits were scheduled 1-3 months after discharge and subsequently at 4, 7, 10, 12, 15, 18, 21, and 24 months and every 6 months thereafter through age 5. The consultation focused on health protection, early diagnosis of growth or developmental delays, and prompt rehabilitation. 74 of 81 infants weighing 500-800 g died, as did 97 of 130 weighing 801-1000 g, 96 of 170 weighing 1001-1200 g, and 108 of 380 weighing 1201-1500 g. The proportion of very low birth weight infants increased from 7.6 to 11.7% of all births between 1983-88 and averaged 8.6% for the 6 years. Surviving infants were hospitalized an average of 33 days with a minimum of 15 and a maximum of 80. 90% of the infants has jaundice, 42% has respiratory disorders or hyaline membrane disease, and 26% has perinatal asphyxia. 76% of very low birth weight infants who were born with asphyxia died, compared to 32% not born asphyxiated. 4 infants has retinopathy related to prematurity. The children were on average in the 5th percentile of the National Center for Health Statistics weight curve and height curve at 5 years. The average head circumference was on the 10th percentile from 1 year of age. The mean differences from the normal standard at 5 years were 3180g for weight, 7 cm for height, and 1 cm for head circumference. 35% of infants has problems in large motor skills in the 1st year, but by the 2nd year only those with diagnoses of neurological problems still had problems with large motor skills. Over 50% showed delay in language development at 3 years, but by 5 years only 12% still had problems. Over 85% has delays in fine motor skills development from the 1st through the 5th year. Socioeconomics factors were the most important cause of failure to thrive and develop. Only 33% of the mothers had had prenatal care before the 7th month of pregnancy.^ieng
