Neonatal risk factors and later neurodevelopmental disturbances.

Background factors of developmental outcome in a group of 386 neonatal 'at-risk' infants and 107 controls were examined in a prospective nine-year follow-up study. Dichotomized outcome variables were computed for each of the assessments; neurodevelopmental, motor, psycholinguistic, cognitive and school progress. In the study group, 17 to 29 per cent were found to have significant problems, compared with 10 to 17 per cent of the control group. Children with low birthweight, neonatal neurological symptoms or several neonatal disorders were found to have most problems at the age of nine years. In stepwise logistic regression analyses, smallness for gestational age, neonatal signs of cerebral depression and low social-class were found to be the most significant predictors of neurodevelopmental problems at age nine. Factors suggesting intra-uterine hypoxia or poor nutrition were also associated with developmental problems. The background pathology of the neonatal conditions seemed to be of more importance than the neonatal manifestations themselves.

Nine-year follow-up of infants weighing 1 500 g or less at birth.

A nine-year follow-up of 116 children born consecutively in 1971-74 with a birthweight of 1 500 g or less showed that 59 had died. Of those who were alive, four had severe motor and/or mental handicaps and three were blind because of retrolental fibroplasia. The low birthweight children without severe handicaps were found to have impaired motor function, speech defects and impaired school achievement more often than the controls. There was a significant correlation between the test results at the age of five and nine years, which indicates that children with school failure can be recognized and early remedial treatment started before school or on starting school.